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Alsadiq S, Kartolo A, McWhirter E, Hopman W, Baetz T. Efficacy and safety of adjuvant systemic therapies in trial non-eligible resected stages III and IV melanoma patients. Melanoma Manag 2025; 12:2461963. [PMID: 39960333 PMCID: PMC11834428 DOI: 10.1080/20450885.2025.2461963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 01/30/2025] [Indexed: 02/20/2025] Open
Abstract
BACKGROUND Adjuvant immunotherapy and targeted therapy are now the standard of care for patients with resected stage IIIA-IV melanoma. However, little is known regarding its efficacy in real-world patients who were not represented in these landmark trials. METHODS This retrospective study included all patients with resected stage IIIA-IV melanoma who received adjuvant systemic therapy between January 1 2018 and December 31 2020, in two Canadian academic cancer. Primary outcome was the proportion of trial non-eligible patients in the real-world setting. Survival and safety analyses were also conducted. RESULTS Of the total 113 patient, 99 (88%) were trial non-eligible patients. Most common reasons for trial non-eligible criteria was having no baseline CLND (72%), followed by outside of treatment window >12 weeks (30%), stage IIIA (14%), unknown primary (9%), stage IV (14%), and baseline AD on immunosuppressants (3%). There were no significant RFS (P = 0.731) or OS (P = 0.110) differences in the overall population of trial eligible vs. non-eligible. Safety profiles were similar between the trial eligible vs. non-eligible groups. CONCLUSION Our study suggested a high proportion of real-world patients would have been deemed non-eligible for clinical trials. Regardless, adjuvant systemic therapy delivered similar survival and toxicity outcomes in both groups.
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Affiliation(s)
- Sarah Alsadiq
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
- Department of Oncology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Adi Kartolo
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Elaine McWhirter
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Wilma Hopman
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Tara Baetz
- Department of Oncology, Queen’s University, Kingston, Ontario, Canada
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Wu QL, Liao Y, Brannon GE. Two sides of trust: How cancer survivors' communication with healthcare providers and on social media predicted healthy behaviors during COVID-19. PATIENT EDUCATION AND COUNSELING 2025; 131:108553. [PMID: 39577306 DOI: 10.1016/j.pec.2024.108553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 10/25/2024] [Accepted: 11/12/2024] [Indexed: 11/24/2024]
Abstract
OBJECTIVES COVID-19 exacerbated pre-existing social inequalities. Using three theories linking clinical and media contexts to patients' health outcomes, our study investigated (1) potential factors of cancer patients' trust in healthcare providers and social media; (2) how such trust may influence healthy lifestyles during COVID-19. METHODS Using structural equation modeling, we investigated effects of key patient-provider communication variables and media factors on healthy behaviors among cancer survivors (N = 1130) using a nationally representative dataset (HINTS-SEER restricted use files, January-July 2021). RESULTS More healthy behaviors since COVID-19 began were associated with more trust in healthcare providers, lower trust in social media about COVID-19, and more use of social media for health purposes. More trust in social media about COVID-19 was associated with more use of social media for health purposes (p < .01). More trust in healthcare providers about COVID-19 was associated with increased perceptions of patient-provider communication (p < .01). CONCLUSIONS Findings can inform interventions to connect at-risk cancer patients (e.g., those younger and with lower educational background) with providers in trust-enhancing conversations during situations like COVID-19. PRACTICE IMPLICATIONS Partnership building between providers and patients can be supplemented with scientific videos on popular social media sites like YouTube during public health crises and emergencies.
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Affiliation(s)
- Qiwei Luna Wu
- Department of Communication Studies, Texas Tech University, Lubbock, TX, USA.
| | - Yue Liao
- Department of Kinesiology, University of Texas Arlington, Arlington, TX, USA.
| | - Grace Ellen Brannon
- Department of Communication, University of Texas Arlington, Arlington, TX, USA.
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Amado-Garzón SB, Molina-Pimienta L, Vásquez-Jiménez JM, Álvarez-Raigoza KL, Manrique-Samer M, Lombo-Moreno CE, Cañas-Arboleda A. Factors influencing in-hospital mortality in cancer patients with COVID-19: A retrospective survival analysis. SAGE Open Med 2024; 12:20503121241295852. [PMID: 39526090 PMCID: PMC11549711 DOI: 10.1177/20503121241295852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/30/2024] [Indexed: 11/16/2024] Open
Abstract
Objective The aim of this study was to evaluate survival in patients with COVID-19 and cancer, and to find factors associated with early mortality. Methods Retrospective cohort derived from a registry of a referral center in Bogotá. Survival was analyzed according to the type of neoplasm using Kaplan-Meier method. A cox regression was performed to look for factors associated to higher risk of death. Results Two hundred fifty-four patients were included with cancer and COVID-19, most of whom were women (median age 68 years; range 19-97). Cardiovascular comorbidities were frequent. Patients with hematologic neoplasms had higher survival than those with solid neoplasms (log-rank test, p = 0.024). C-reactive protein levels (hazard ratio 1.02; 95% confidence interval 1.00-1.03, p = 0.025), Charlson's comorbidity index (hazard ratio 1.15; 95% confidence interval 1.06-1.26, p = 0.004) and respiratory failure (hazard ratio 4.83; 95% confidence interval 2.47-9.44, p = <0.001) were significantly associated with higher mortality. No interaction between active anticancer therapy and mortality was observed. Conclusion In contrast to other reports, survival was worse in patients with solid tumors than in those with hematologic neoplasms. Increased C-reactive protein, Charlson's comorbidity index and respiratory failure were associated with higher in-hospital mortality. This study reveals the complex impact of cancer and its treatment on COVID-19 outcomes, highlighting the persistent risks to cancer patients. It emphasizes monitoring C-reactive protein levels, comorbidities, and respiratory failure as key indicators of poor prognosis. Furthermore, we provide new insights into the differential impact of COVID-19 on cancer patients with solid organ versus hematologic neoplasms.
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Affiliation(s)
- Sandra Brigitte Amado-Garzón
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luisana Molina-Pimienta
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juan Manuel Vásquez-Jiménez
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Karen Lizeth Álvarez-Raigoza
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mauricio Manrique-Samer
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos E Lombo-Moreno
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Alejandra Cañas-Arboleda
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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Georgescu I, Artene SA, Giubelan LI, Tache DE, Dumitrescu F, Duta C, Mirea AA, Manea Carneluti EV, Dricu A, Popescu OS. Evaluation of the Demographics, Clinical Laboratory Parameters, and Outcomes of Hospitalized Oncological Versus Non-oncological COVID-19 Patients. Cureus 2024; 16:e73313. [PMID: 39655133 PMCID: PMC11626416 DOI: 10.7759/cureus.73313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2024] [Indexed: 12/12/2024] Open
Abstract
Introduction The COVID-19 pandemic emerged globally in 2019, exposing healthcare vulnerabilities. This study delves into the impact of COVID-19 on cancer patients, a high-risk group with increased susceptibility and mortality rates. Recent research underscores cancer patients' vulnerability to severe disease, often due to compromised immunity. Materials and methods This retrospective study analyzed data from 474 adult COVID-19 patients, admitted between March 2020 and July 2023. Patients were categorized into two groups: those with a medically recorded oncological disease (237) and those without any malignant history (237). Demographic and hematologic analysis aim to unveil COVID-19 impact on individuals with cancer history. Results Statistically significant differences in blood parameters highlighted distinctions, with cancer patients exhibiting higher creatinine, leukocyte, and D Dimers levels as well as lower hemoglobin, neutrophile, lymphocyte, and Serum Glutamate-Pyruvate Transaminase (SGPT) levels. Non-significant differences in certain parameters prompted a nuanced exploration of metabolic and coagulation variations. Conclusion This study unveils global COVID-19 effects on cancer patients, emphasizing clinical and laboratory differences. Findings underscore the imperative need for targeted interventions and enhanced support for cancer patients during the pandemic. Study limitations stress careful interpretation, urging further exploration of COVID-19 and cancer interplay.
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Affiliation(s)
- Ilona Georgescu
- Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, ROU
- Infectious Diseases, "Victor Babeş" Clinical Hospital of Infectious Diseases and Pneumo-phtisiology, Craiova, ROU
| | - Stefan Alexandru Artene
- Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, ROU
| | - Lucian-Ion Giubelan
- Infectious Diseases, "Victor Babeş" Clinical Hospital of Infectious Diseases and Pneumo-phtisiology, Craiova, ROU
| | - Daniela Elise Tache
- Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, ROU
| | - Florentina Dumitrescu
- Infectious Diseases, "Victor Babeş" Clinical Hospital of Infectious Diseases and Pneumo-phtisiology, Craiova, ROU
| | - Carmen Duta
- Biochemistry, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | - Adina Andreea Mirea
- Dental Medicine, University of Medicine and Pharmacy of Craiova, Craiova, ROU
| | | | - Anica Dricu
- Biochemistry, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | - Oana Stefana Popescu
- Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, ROU
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Hoveidaei A, Karimi M, Khalafi V, Fazeli P, Hoveidaei AH. Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases. World J Orthop 2024; 15:841-849. [PMID: 39318492 PMCID: PMC11417628 DOI: 10.5312/wjo.v15.i9.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/31/2024] [Accepted: 08/15/2024] [Indexed: 09/12/2024] Open
Abstract
Bone metastases (BM) are a common complication in advanced cancer patients, significantly contributing to morbidity and mortality due to their ability to cause pain, fractures, and spinal cord compression. Radiation therapy (RT) is vital in managing these complications by targeting metastatic lesions to ease pain, improve mobility, and reduce the risk of skeletal-related events such as fractures. Evidence supports the effectiveness of RT in pain relief, showing its ability to provide significant palliation and lessen the need for opioid painkillers, thereby enhancing the overall quality of life (QoL) for patients with BM. However, optimizing RT outcomes involves considerations such as the choice of radiation technique, dose fractionation schedules, and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions. These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics. This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients, with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.
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Affiliation(s)
- Armin Hoveidaei
- Students’ Scientific Research Center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran
| | - Mehdi Karimi
- Bogomolets National Medical University, Kyiv 01601, Ukraine
| | - Vida Khalafi
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom 7413188941, Iran
| | | | - Amir Human Hoveidaei
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, United States
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Karabulut I, Demirdogen SO, Ramazanoglu MA, Sam E, Cinislioglu AE, Al S, Altay MS, Yilmazel FK, Bicaklioglu F, Aydin HR, Adanur S. Desires and attitudes of outpatients and physicians regarding the use of teleurology during the pandemic: a prospective survey study. Aktuelle Urol 2024; 55:430-438. [PMID: 35172348 DOI: 10.1055/a-1648-2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE It is not known to date how many patients admitted to urology outpatient clinics are willing to use telemedicine. We aimed to investigate knowledge levels and attitudes concerning the utilization of teleurology by patients applying to urology outpatient clinics. METHODS This prospective multicentre survey study included 334 patients aged 18-65 years who applied to an urology outpatient clinics. The patients were asked questions about their attitudes and expectations regarding teleurology. Diseases were divided into seven subgroups due to the broad spectrum of diagnoses. Physicians' and patients' opinions on whether it was possible to manage the current medical condition via teleurology were recorded. RESULTS 69.5% of patients stated that they had sufficient technical skills to use teleurology by themselves for medical examination. 55.4% of patients and 78.4% of physicians responded that the existing complaints were suitable for teleurology. Both patients and physicians deemed genital system diseases and urinary tract infections suitable for teleurology (p<0.001, p<0.001 for physicians, and p<0.001, p<0.001 for patients), whereas urine transport, storage and emptying disorders (p=0.003) and benign prostatic hyperplasia (p=0.029) were deemed to be suitable for teleurology only by the physicians. CONCLUSION Our study shows that (i) the majority of our patient population has a telecommunications infrastructure suitable for teleurology, (ii) teleurology has aroused interest among patients, particularly during the pandemic period, and (iii) physicians and patients have high expectations that the problem can be solved with teleurology in suitable patients.
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Affiliation(s)
- Ibrahim Karabulut
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Saban Oguz Demirdogen
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Mehmet Akif Ramazanoglu
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Emre Sam
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Ahmet Emre Cinislioglu
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Salih Al
- Urology, Ataturk University Faculty of Medicine, Ezurum, Turkey
| | - Mehmet Sefa Altay
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Kursat Yilmazel
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Bicaklioglu
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Hasan Riza Aydin
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Senol Adanur
- Urology, Ataturk University Faculty of Medicine, Ezurum, Turkey
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Magon H, Smith J, Besson J, Hau E, Taylor S, Ruben J, Jones D, Mabb K, Feldman J, Gholam Rezaei L, Lee YY. Adapting to change: exploring perceptions and demands of the coronavirus (COVID-19) workforce changes - an Australian multi-institutional radiation oncology survey. AUST HEALTH REV 2024; 48:388-395. [PMID: 38467124 DOI: 10.1071/ah23183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
Objective To evaluate the perceptions of the coronavirus disease 2019 (COVID-19) initiated workplace strategies implemented in radiation oncology departments across Australia. Methods A multidisciplinary team from Princess Alexandra Hospital developed a survey to address the impact of the pandemic strategies on areas such as patient care, staff education, well-being, flexible working arrangements, and research. The survey was conducted from November 2020 to April 2021. Results Out of 210 respondents from seven institutions, 45% reported burnout and 57% experienced work work-related stress. A significant majority of respondents were in favour of continued remote work (86%, 131/153). Radiation oncologists identified administrative or non-clinical work (92%, 34/37), telehealth clinics (32%, 12/37), or radiation therapy planning (22%, 8/37) as suitable for remote work. Additionally, 54% (21/39) of the radiation oncologists plan to use telehealth more frequently, with 67% (26/39) feeling more confident with the technology. The majority (81%, 171/210) of participants favoured continuation of hybrid in-person and virtual meetings. Virtual solutions were adopted for quality assurance activities (72%, 118/165) and 52% (60/116) indicated preference for ongoing utility of virtual platforms. However, 38% (79/210) of the respondents expressed concerns about the negative impact on junior staff training. Conclusion These findings reveal a strong inclination towards technological advancements and remote work arrangements to enable flexible working conditions. Our study suggests the need for ongoing reforms, focusing on improving clinical service delivery efficiencies and enhancing job satisfaction among clinicians.
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Affiliation(s)
- Honor Magon
- Digital Health and Informatics, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld 4102, Australia
| | - Justin Smith
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia; and Faculty of Medicine, University of QLD, Brisbane, Qld, Australia; and College of Medicine and Dentistry, James Cook University, Townsville, Qld, Australia
| | - Jacqueline Besson
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia
| | - Eric Hau
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia; and Blacktown Haematology and Oncology Cancer Cente, Blacktown Hospital, Sydney, NSW, Australia; and Westmead Institute of Medical Research, Sydney, NSW, Australia; and Westmead Medical School, University of Sydney, Sydney, NSW, Australia
| | - Suzanne Taylor
- Faculty of Medicine, University of QLD, Brisbane, Qld, Australia; and Department of Radiation Oncology, Princess Alexandra Hospital Raymond Terrace Campus, Brisbane, Qld, Australia
| | | | - Diana Jones
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia
| | - Kira Mabb
- Department of Nutrition and Dietetics, Princess Alexandra Hospital Ipswich Road Campus, Brisbane, Qld, Australia
| | - Jamie Feldman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital Ipswich Road Campus, Brisbane, Qld, Australia
| | - Leily Gholam Rezaei
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - Yoo Young Lee
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia; and Faculty of Medicine, University of QLD, Brisbane, Qld, Australia
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Jackson RW, Cao-Nasalga A, Chieng A, Pirkl A, Jagielo AD, Xu C, Goldenhersch E, Rosencovich N, Waitman C, Prochaska JJ. Adding Virtual Reality Mindful Exposure Therapy to a Cancer Center's Tobacco Treatment Offerings: Feasibility and Acceptability Single-Group Pilot Study. JMIR Form Res 2024; 8:e54817. [PMID: 39042439 PMCID: PMC11303906 DOI: 10.2196/54817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Smoking contributes to 1 in 3 cancer deaths. At the Stanford Cancer Center, tobacco cessation medication management and counseling are provided as a covered benefit. Patients charted as using tobacco are contacted by a tobacco treatment specialist and offered cessation services. As a novel addition, this study examined the acceptability of a virtual reality (VR) mindful exposure therapy app for quitting smoking called MindCotine. OBJECTIVE The objective of this study was to determine the feasibility and acceptability of offering 6 weeks of MindCotine treatment as a part of Stanford's Tobacco Treatment Services for patients seen for cancer care. METHODS As part of a single-group pilot study, the MindCotine VR program was offered to English- or Spanish-speaking patients interested in quitting smoking. Given the visual interface, epilepsy was a medical exclusion. Viewed from a smartphone with an attachable VR headset, MindCotine provides a digital environment with audiovisual content guiding mindfulness exercises (eg, breathing techniques, body awareness, and thought recognition), text-based coaching, and cognitive behavioral therapy-based self-reflections for quitting smoking. Interested patients providing informed consent were mailed a MindCotine headset and asked to use the app for 10+ minutes a day. At the end of 6 weeks, participants completed a feedback survey. RESULTS Of the 357 patients reached by the tobacco treatment specialist, 62 (17.3%) were ineligible, 190 (53.2%) were not interested in tobacco treatment services, and 78 (21.8%) preferred other tobacco treatment services. Among the 105 eligible and interested in assistance with quitting, 27 (25.7%) were interested in MindCotine, of whom 20 completed the informed consent, 9 used the program, and 8 completed their end-of-treatment survey. Participants using MindCotine completed, on average, 13 (SD 20.2) program activities, 19 (SD 26) journal records, and 11 (SD 12.3) coaching engagements. Of the 9 participants who used MindCotine, 4 (44%) reported some dizziness with app use that resolved and 7 (78%) would recommend MindCotine to a friend. In total, 2 participants quit tobacco (22.2% reporting, 10% overall), 2 others reduced their smoking by 50% or more, and 2 quit for 24 hours and then relapsed. CONCLUSIONS In a feasibility and acceptability pilot study of a novel VR tobacco treatment app offered to patients at a cancer center, 4 of 9 (44%) reporting and 4 of 20 (20%) overall substantially reduced or quit using tobacco after 6 weeks and most would recommend the app to others. Further testing on a larger sample is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT05220254; https://clinicaltrials.gov/study/NCT05220254.
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Affiliation(s)
| | - Ann Cao-Nasalga
- Health Education, Engagement and Promotion, Stanford Health Care, Stanford, CA, United States
| | - Amy Chieng
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA, United States
| | - Amy Pirkl
- Health Education, Engagement and Promotion, Stanford Health Care, Stanford, CA, United States
| | - Annemarie D Jagielo
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA, United States
| | - Cindy Xu
- Health Education, Engagement and Promotion, Stanford Health Care, Stanford, CA, United States
| | - Emilio Goldenhersch
- Laboratorio de Investigación en Neurociencia y Ciencias Sociales, Universidad de Flores, Buenos Aires, Argentina
| | - Nicolas Rosencovich
- Escuela de Ingeniería Biomédica, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA, United States
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Carmona J, Chavarria E, Donoghue K, von Gertten C, Oberrauch P, Pailler E, Scoazec G, Weijer R, Balmaña J, Brana I, Brunelli C, Delaloge S, Deloger M, Delpy P, Ernberg I, Fitzgerald RC, Garralda E, Lablans M, Lëhtio J, Lopez C, Fernández M, Miceli R, Nuciforo P, Perez-Lopez R, Provenzano E, Schmidt MK, Serrano C, Steeghs N, Tamborero D, Wirta V, Baird RD, Barker K, Barlesi F, Baumann M, Bergh J, de Braud F, Fizazi K, Fröhling S, Piris-Giménez A, Seamon K, Van der Heijden MS, Zwart W, Tabernero J. Cancer Core Europe: Leveraging Institutional Synergies to Advance Oncology Research and Care Globally. Cancer Discov 2024; 14:1147-1153. [PMID: 38870393 DOI: 10.1158/2159-8290.cd-24-0377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
Cancer Core Europe brings together the expertise, resources, and interests of seven leading cancer institutes committed to leveraging collective innovation and collaboration in precision oncology. Through targeted efforts addressing key medical challenges in cancer and partnerships with multiple stakeholders, the consortium seeks to advance cancer research and enhance equitable patient care.
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Affiliation(s)
- Javier Carmona
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Elena Chavarria
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Kate Donoghue
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | | | - Petra Oberrauch
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | | | - Giovanni Scoazec
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ruud Weijer
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Judith Balmaña
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Irene Brana
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Suzette Delaloge
- Interception Programme, Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | | | - Pierre Delpy
- Federated Information Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Complex Medical Informatics, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
| | - Ingemar Ernberg
- Department of Microbiology, Tumor and Cell Biology (MTC), Cancer Center Karolinska (CCK) & Biomedicum. Karolinska Institutet, Stockholm, Sweden
| | - Rebecca C Fitzgerald
- Department of Oncology, Early Cancer Institute, University of Cambridge, Cambridge, United Kingdom
| | - Elena Garralda
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Martin Lablans
- Federated Information Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Complex Medical Informatics, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
| | - Janne Lëhtio
- Department of Oncology and Pathology, Karolinska Institutet, SciLifeLab, Solna, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Carlos Lopez
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Rosalba Miceli
- Unit of Biostatistics for Clinical Research, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paolo Nuciforo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Elena Provenzano
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Marjanka K Schmidt
- Division of Molecular Pathology, NKI Center for Early Diagnostics, Lead Early Detection Research Theme, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Cesar Serrano
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Neeltje Steeghs
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - David Tamborero
- Department of Oncology and Pathology, Karolinska Institutet, SciLifeLab, Solna, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Valtteri Wirta
- Department of Microbiology, Tumor and Cell Biology, Karolinska Instiutet, Stockholm, Sweden
- Genomic Medicine Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Richard D Baird
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Karen Barker
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Fabrice Barlesi
- Gustave Roussy, Villejuif, France
- Paris Saclay University, Villejuif, France
| | - Michael Baumann
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Jonas Bergh
- Karolinska Institutet, Stockholm, Sweden
- Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Solna, Sweden
| | - Filippo de Braud
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Stefan Fröhling
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | | | - Kenneth Seamon
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | | | - Wilbert Zwart
- Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Josep Tabernero
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
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10
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Horgan D, Van den Bulcke M, Malapelle U, Normanno N, Capoluongo ED, Prelaj A, Rizzari C, Stathopoulou A, Singh J, Kozaric M, Dube F, Ottaviano M, Boccia S, Pravettoni G, Cattaneo I, Malats N, Buettner R, Lekadir K, de Lorenzo F, Alix-Panabieres C, Badreh S, Solary E, De Maria R, Hofman P. Demographic Analysis of Cancer Research Priorities and Treatment Correlations. Curr Oncol 2024; 31:1839-1864. [PMID: 38668042 PMCID: PMC11048756 DOI: 10.3390/curroncol31040139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/07/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Understanding the diversity in cancer research priorities and the correlations among different treatment modalities is essential to address the evolving landscape of oncology. This study, conducted in collaboration with the European Cancer Patient Coalition (ECPC) and Childhood Cancer International-Europe (CCI-E) as part of the "UNCAN.eu" initiative, analyzed data from a comprehensive survey to explore the complex interplay of demographics, time since cancer diagnosis, and types of treatments received. Demographic analysis revealed intriguing trends, highlighting the importance of tailoring cancer research efforts to specific age groups and genders. Individuals aged 45-69 exhibited highly aligned research priorities, emphasizing the need to address the unique concerns of middle-aged and older populations. In contrast, patients over 70 years demonstrated a divergence in research priorities, underscoring the importance of recognising the distinct needs of older individuals in cancer research. The analysis of correlations among different types of cancer treatments underscored the multidisciplinary approach to cancer care, with surgery, radiotherapy, chemotherapy, precision therapy, and biological therapies playing integral roles. These findings support the need for personalized and combined treatment strategies to achieve optimal outcomes. In conclusion, this study provides valuable insights into the complexity of cancer research priorities and treatment correlations in a European context. It emphasizes the importance of a multifaceted, patient-centred approach to cancer research and treatment, highlighting the need for ongoing support, adaptation, and collaboration to address the ever-changing landscape of oncology.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium; (J.S.); (M.K.)
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Faculty of Engineering and Technology, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | | | - Umberto Malapelle
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy;
| | - Nicola Normanno
- Istituto Nazionale Tumori “Fondazione G. Pascale”—IRCCS, 80131 Naples, Italy;
| | - Ettore D. Capoluongo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80138 Naples, Italy;
- Department of Clinical Pathology, Azienda Ospedaliera San Giovanni Addolorata, Via Amba Aradam 8, 00184 Rome, Italy
| | - Arsela Prelaj
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy;
| | - Carmelo Rizzari
- Unità di Ematologia Pediatrica, Fondazione MBBM, Università di Milano-Bicocca, 20126 Monza, Italy;
| | - Aliki Stathopoulou
- European Cancer Patient Coalition, 1000 Brussels, Belgium; (A.S.); (F.d.L.)
| | - Jaya Singh
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium; (J.S.); (M.K.)
| | - Marta Kozaric
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium; (J.S.); (M.K.)
| | - France Dube
- Astra Zeneca, Concord Pike, Wilmington, DE 19803, USA;
| | - Manuel Ottaviano
- Departamento de Tecnología Fotónica y Bioingeniería, Universidad Politècnica de Madrid, 28040 Madrid, Spain;
| | - Stefania Boccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 20123 Rome, Italy;
- Departments of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO) IRCCS, 20139 Milan, Italy
| | | | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain;
| | - Reinhard Buettner
- Lung Cancer Group Cologne, Institute of Pathology, Center for Integrated Oncology Cologne/Bonn, University Hospital Cologne, 50937 Cologne, Germany;
| | - Karim Lekadir
- Artificial Intelligence in Medicine Lab (BCN-AIM), Universitat de Barcelona, 08007 Barcelona, Spain;
| | | | - Catherine Alix-Panabieres
- Laboratory of Rare Human Circulating Cells, University Medical Center of Montpellier, 34093 Montpellier, France;
| | - Sara Badreh
- Cancer Childhood International, 1200 Vienna, Austria;
| | - Eric Solary
- INSERM U1287, Gustave Roussy Cancer Campus, 94805 Paris, France;
- Faculty of Medicine, Université Paris-Sud, 91405 Le Kremlin-Bicêtre, Île-de-France, France
- Department of Hematology, Gustave Roussy Cancer Campus, 94805 Paris, France
| | - Ruggero De Maria
- Institute of General Pathology, Catholic University of the Sacred Heart, 20123 Rome, Italy;
| | - Paul Hofman
- IHU RespirERA, FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France;
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11
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Inwald EC, Klinkhammer-Schalke M, Müller-Nordhorn J, Voigtländer S, Gerken M, Behrens B, Fehm TN, Ortmann O. Auswirkungen der COVID-19-Pandemie auf das Krebsgeschehen in Deutschland. DIE GYNÄKOLOGIE 2024; 57:3-8. [DOI: 10.1007/s00129-023-05177-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 01/05/2025]
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12
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Nouhi M, Bijlmakers L, Goudarzi Z, Alipour S, Hakimzadeh SM, Nazari P, Jahangiri R, Heydari M. Future challenges and opportunities for cancer screening in the COVID-19 era. HEALTH POLICY AND TECHNOLOGY 2023; 12:100808. [DOI: 10.1016/j.hlpt.2023.100808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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13
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Siwik CJ, Jhaveri K, Cohen JA, Barulich M, Chang A, Levin AO, Goyal NG, Melisko M, Chesney MA, Shumay D. Survivorship wellness: a multidisciplinary group program for cancer survivors. Support Care Cancer 2023; 31:655. [PMID: 37882860 PMCID: PMC10602945 DOI: 10.1007/s00520-023-08117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE National mandates require cancer centers provide comprehensive survivorship care. We created an 8-session, group intervention, the Survivorship Wellness Group Program (SWGP), that covered 8 topics: nutrition, physical activity, stress, sleep/fatigue, sexuality/body image, emotional wellbeing/fear of cancer recurrence, spirituality/meaning, and health promotion/goal setting. This study examined the acceptability and preliminary outcomes of SWGP. METHODS We evaluated SWGP using questionnaire data collected at program entry and 15-week follow-up. Questionnaires assessed acceptability and impact on anxiety, depression, quality of life, and perceived knowledge of topics. Enrollees who consented to participate in research and completed the baseline and 15-week follow-up were included in the analysis (N = 53). We assessed acceptability and preliminary outcomes using paired-samples t-tests. Due to the COVID-19 pandemic, SWGP transitioned to telehealth partway through data collection. Post-hoc analyses compared outcomes by intervention delivery. RESULTS Participants completed an average of 7.44/8 classes. Participants reported a mean response of 3.42/4 regarding overall program satisfaction and 90.6% reported being "very likely" to recommend SWGP. SWGP was associated with decreases in anxiety and depression; increases in physical, emotional, functional, and overall quality of life; and increases in knowledge of all health behavior domains. No outcomes differed significantly between delivery in person versus telehealth. CONCLUSIONS SWGP offers an acceptable and replicable model for cancer centers to meet national survivorship care guidelines. IMPLICATION FOR CANCER SURVIVORS SWGP provides a comprehensive service for cancer survivors post-treatment, and was associated with better quality of life, fewer mental health symptoms, and increased knowledge in multiple domains of wellness.
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Affiliation(s)
- Chelsea J Siwik
- Osher Center for Integrative Health, University of California, San Francisco, CA, USA
| | - Kinnari Jhaveri
- Osher Center for Integrative Health, University of California, San Francisco, CA, USA
| | - Jamie Alexis Cohen
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA.
| | - Mikela Barulich
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
| | - Alison Chang
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
| | - Anna O Levin
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
| | - Neha G Goyal
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
| | - Michelle Melisko
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
| | - Margaret A Chesney
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Dianne Shumay
- Helen Diller Family Comprehensive Cancer Center, University of California, 1600 Divisadero Street, Fourth Floor, San Francisco, CA, 94115, USA
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14
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Elsharkawy A, Samir R, Abdallah M, Hassany M, El-Kassas M. The implications of the COVID-19 pandemic on hepatitis B and C elimination programs in Egypt: current situation and future perspective. EGYPTIAN LIVER JOURNAL 2023; 13:50. [DOI: 10.1186/s43066-023-00290-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 09/26/2023] [Indexed: 04/03/2025] Open
Abstract
AbstractHepatitis B virus (HBV) and hepatitis C virus (HCV) are amongst the most common causative agents of viral hepatitis with its severe complications, including liver cirrhosis, decompensation, and hepatocellular carcinoma (HCC). Elimination of viral hepatitis, a significant challenge, has become an adopted global goal with certainly designed targets set by the World Health Assembly to be met by 2030. While many countries, including Egypt, have started executive plans for viral hepatitis elimination and achieved remarkable progress, the emergence of the COVID-19 pandemic has markedly affected all the machinery of the healthcare systems and specifically laid countries off their track in their viral hepatitis elimination process. The pandemic disrupted most healthcare services, and health staff and hospital resources were recruited mainly for managing the crisis, which significantly negatively impacted the management of other less severe diseases, including viral hepatitis. Social distancing and restrictive measures applied by most countries to contain the pandemic have affected medical services offered to patients with hepatitis. All supply chains of medications and vaccinations concerned with treating and preventing viral hepatitis have been markedly compromised. Many efforts and strategies are required to combat the severe and deleterious implications of the pandemic on the management of viral hepatitis worldwide in an attempt to get the situation under control and resume the pathway towards viral hepatitis elimination.
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15
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Zeilinger EL, Knefel M, Schneckenreiter C, Pietschnig J, Lubowitzki S, Unseld M, Füreder T, Bartsch R, Masel EK, Adamidis F, Kum L, Kiesewetter B, Zöchbauer-Müller S, Raderer M, Krauth MT, Staber PB, Valent P, Gaiger A. The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients. Int J Clin Health Psychol 2023; 23:100404. [PMID: 37663044 PMCID: PMC10469068 DOI: 10.1016/j.ijchp.2023.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Objective We aimed to investigate the impact of the COVID-19 pandemic on psychological symptom burden against the socioeconomic background of cancer patients using data from routine assessments before and during the pandemic. Method In this cross-sectional study, standardised assessment instruments were applied in N = 1,329 patients to screen for symptoms of anxiety, depression, post-traumatic stress, and fatigue from 2018 to 2022. Two MANOVAs with post-hoc tests were computed. First, only time was included as predictor to examine the isolated impact of the pandemic. Second, income level and education level were included as further predictors to additionally test the predictive power of socioeconomic factors. Results In the final model, only income had a significant impact on all aspects of psychological symptom burden, with patients with low income being highly burdened (partial η² = .01, p = .023). The highest mean difference was found for depressive symptoms (MD = 0.13, CI = [0.07; 0.19], p < .001). The pandemic had no further influence on psychological distress. Conclusions Although the pandemic is a major stressor in many respects, poverty may be the more important risk factor for psychological symptom burden in cancer outpatients, outweighing the impact of the pandemic.
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Affiliation(s)
- Elisabeth Lucia Zeilinger
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
| | - Matthias Knefel
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine, Landesklinikum Baden-Mödling, Baden, Austria
| | - Carmen Schneckenreiter
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Simone Lubowitzki
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Thorsten Füreder
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Rupert Bartsch
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Eva Katharina Masel
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Feroniki Adamidis
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Lea Kum
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesewetter
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Sabine Zöchbauer-Müller
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Maria Theresa Krauth
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Philipp B Staber
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Alexander Gaiger
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
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16
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Gremke N, Griewing S, Bausch E, Alymova S, Wagner U, Kostev K, Kalder M. Therapy delay due to COVID-19 pandemic among European women with breast cancer: prevalence and associated factors. J Cancer Res Clin Oncol 2023; 149:11749-11757. [PMID: 37405476 PMCID: PMC10465653 DOI: 10.1007/s00432-023-05065-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE This study investigates the impact of the COVID-19 pandemic on breast cancer (BC) care, analyzing treatment delays and factors associated with them. METHODS This retrospective cross-sectional study analyzed data from the Oncology Dynamics (OD) database. Surveys of 26,933 women with BC performed between January 2021 and December 2022 in Germany, France, Italy, the United Kingdom, and Spain were examined. The study focused on determining the prevalence of treatment delays due to the COVID-19 pandemic, considering factors such as country, age group, treating facility, hormone receptor status, tumor stage, site of metastases, and Eastern Cooperative Oncology Group (ECOG) status. Baseline and clinical characteristics were compared for patients with and without therapy delay using chi-squared tests, and a multivariable logistic regression analysis was conducted to explore the association between demographic and clinical variables and therapy delay. RESULTS The present study found that most therapy delays lasted less than 3 months (2.4%). Factors associated with higher risk of delay included being bedridden (OR 3.62; 95% CI 2.51-5.21), receiving neoadjuvant therapy (OR 1.79; 95% CI 1.43-2.24) compared to adjuvant therapy, being treated in Italy (OR 1.58; 95% CI 1.17-2.15) compared to Germany or treatment in general hospitals and non-academic cancer facilities (OR 1.66, 95% CI 1.13-2.44 and OR 1.54; 95% CI 1.14-2.09, respectively) compared to treatment by office-based physicians. CONCLUSION Addressing factors associated with therapy delays, such as patient performance status, treatment settings, and geographic location, can help guide strategies for improved BC care delivery in the future.
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Affiliation(s)
- Niklas Gremke
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
- Institute of Molecular Oncology, Philipps-University Marburg, Hans-Meerwein-Straße 3, 35043, Marburg, Germany.
| | - Sebastian Griewing
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Elena Bausch
- Real World Solutions, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Svetlana Alymova
- Real World Solutions, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Uwe Wagner
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Karel Kostev
- IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
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Moshtagh M, Mirlashari J, Brown H. Experiences of women with cancer living in the rural areas of Iran during the COVID-19 pandemic: a qualitative study. Support Care Cancer 2023; 31:376. [PMID: 37273068 DOI: 10.1007/s00520-023-07847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE This study aimed to explore the challenges of access to treatment and quality of life in female cancer survivors living in rural areas of Iran within the global pandemic context (COVID-19). METHODS We conducted a qualitative exploratory study where we recruited nine female-identifying individuals diagnosed with cancer, 23 family members, and five healthcare providers from a hospital affiliated with the Birjand University of Medical Sciences in Iran. Data was collected using semi-structured interviews and analyzed using Braun and Clarke's reflective thematic analysis. RESULTS The three themes constructed were lack of strength from fighting on two fronts (subthemes: (i) fear related to longevity and life span, (ii) disruption of emotional relationships and family functioning, (iii) loneliness and fear of the future, (iv) village culture and double whammy, and (v) isolation and rejection in a rural community); changes during treatment (subthemes: (i) confusion related to treatment and (ii) the hope found during treatment "bottlenecks"); and spiritual growth and clarifying values (subthemes: (i) patience and resilience and (ii) clarifying life values and opportunities when facing uncertainty about the future). CONCLUSION This study highlights the importance of further evaluating interventions to mitigate barriers to supportive care for female cancer survivors living in rural areas with low-resource contexts during the COVID-19 pandemic.
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Affiliation(s)
- Mozhgan Moshtagh
- Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.
| | | | - Helen Brown
- University of British Columbia, School of Nursing, Vancouver, Canada
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Caliandro M, Carbonara R, Surgo A, Ciliberti MP, Di Guglielmo FC, Bonaparte I, Paulicelli E, Gregucci F, Turchiano A, Fiorentino A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Curr Oncol 2023; 30:5158-5167. [PMID: 37232848 DOI: 10.3390/curroncol30050390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
AIM In our radiation departments, all patients received psycho-oncological support during RT and during follow-up. Based on the latter, the aim of this retrospective analysis was to evaluate the role of tele-visits and in-person psychological support for cancer patients after RT, and to report a descriptive analysis pointing out the needs of psychosocial intervention in a radiation department during radiation treatment. METHODS According to our institutional care management, all patients receiving RT were prospectively enrolled to receive charge-free assessment of their cognitive, emotional and physical states and psycho-oncological support during treatment. For the whole population who accepted the psychological support during RT, a descriptive analysis was reported. For all patients who agreed to be followed up by a psycho-oncologist, at the end of RT, a retrospective analysis was conducted to evaluate the differences between tele-consultations (video-call or telephone) and on-site psychological visits. Patients were followed up by on-site psychological visit (Group-OS) or tele-consult (Group-TC) visit. For each group, to evaluate anxiety, depression and distress, the Hospital Anxiety Depression Scale (HADS), Distress Thermometer and Brief COPE (BC) were used. RESULTS From July 2019 to June 2022, 1145 cases were evaluated during RT with structured psycho-oncological interviews for a median of 3 sessions (range 2-5). During their first psycho-oncological interview, all the 1145 patients experienced the assessment of anxiety, depression and distress levels with the following results: concerning the HADS-A scale, 50% of cases (574 patients) reported a pathological score ≥8; concerning the HADS-D scale, 30% of cases (340 patients) reported a pathological score ≥8, concerning the DT scale, 60% (687 patients) reported a pathological score ≥4. Eighty-two patients were evaluated after RT: 30 in the Group-OS and 52 in the Group-TC. During follow-up, a median of 8 meetings (range 4-28) were performed. Comparing psychological data at baseline (beginning of RT) and at the last follow-up, in the entire population, a significant improvement in terms of HADS-A, global HADS and BC was shown (p 0.04; p 0.05; and p 0.0008, respectively). Compared to baseline, statistically significant differences were observed between the two groups in terms of anxiety in favor of on-site visit: Group-OS reported a better anxiety score compared with Group-TC. In each group, a statistical improvement was observed in BC (p 0.01). CONCLUSION The study revealed optimal compliance to tele-visit psychological support, even if the anxiety could be better controlled when patients were followed up on-site. However, rigorous research on this topic is needed.
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Affiliation(s)
- Morena Caliandro
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Roberta Carbonara
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Maria Paola Ciliberti
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fiorella Cristina Di Guglielmo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Ilaria Bonaparte
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Eleonora Paulicelli
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fabiana Gregucci
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Angela Turchiano
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alba Fiorentino
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
- Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy
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Bargon CA, Mink van der Molen DR, Batenburg MCT, van Stam LE, van Dam IE, Baas IO, Veenendaal LM, Maarse W, Sier M, Schoenmaeckers EJP, Burgmans JPJ, Bijlsma RM, van der Leij F, Doeksen A, Young-Afat DA, Verkooijen HM. Physical and mental health of breast cancer patients and survivors before and during successive SARS-CoV-2-infection waves. Qual Life Res 2023:10.1007/s11136-023-03400-6. [PMID: 37016089 PMCID: PMC10072805 DOI: 10.1007/s11136-023-03400-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE During the first SARS-CoV-2-infection wave, a deterioration in emotional well-being and increased need for mental health care were observed among patients treated or being treated for breast cancer. In this follow-up study, we assessed patient-reported quality of life (QoL), physical functioning, and psychosocial well-being during the second SARS-CoV-2-infection wave in a large, representative cohort. METHODS This longitudinal cohort study was conducted within the prospective, multicenter UMBRELLA breast cancer cohort. To assess patient-reported QoL, physical functioning and psychosocial well-being, COVID-19-specific surveys were completed by patients during the first and second SARS-CoV-2-infection waves (April and November 2020, respectively). An identical survey was completed by a comparable reference population during the second SARS-CoV-2-infection waves. All surveys included the validated EORTC-QLQ-C30/BR23, HADS and "De Jong-Gierveld Loneliness" questionnaires. Pre-COVID-19 EORTC-QLQ-C30/BR23 and HADS outcomes were available from UMBRELLA. Response rates were 69.3% (n = 1106/1595) during the first SARS-CoV-2-infection wave and 50.9% (n = 822/1614) during the second wave. A total of 696 patients responded during both SARS-CoV-2-infection waves and were included in the analysis comparing patient-reported outcomes (PROs) during the second SARS-CoV-2-infection wave to PROs during the first wave. Moreover, PROs reported by all patients during the second SARS-CoV-2-infection wave (n = 822) were compared to PROs of a similar non-cancer reference population (n = 241) and to their pre-COVID-19 PROs. RESULTS Patient-reported QoL, physical functioning, and psychosocial well-being of patients treated or being treated for breast cancer remained stable or improved from the first to the second SARS-CoV-2-infection wave. The proportion of emotional loneliness reduced from 37.6 to 29.9% of patients. Compared to a similar non-cancer reference population, physical, emotional, and cognitive functioning, future perspectives and symptoms of dyspnea and insomnia were worse in patients treated or being treated for breast cancer during the second SARS-CoV-2-infection wave. PROs in the second wave were similar to pre-COVID-19 PROs. CONCLUSION Although patients scored overall worse than individuals without breast cancer, QoL, physical functioning, and psychosocial well-being did not deteriorate between the first and second wave. During the second wave, PROs were similar to pre-COVID-19 values. Overall, current findings are cautiously reassuring for future mental health of patients treated or being treated for breast cancer.
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Affiliation(s)
- Claudia A Bargon
- Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands.
| | - Dieuwke R Mink van der Molen
- Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marilot C T Batenburg
- Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Lilianne E van Stam
- Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Iris E van Dam
- Department of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, The Netherlands
| | - Inge O Baas
- Department of Medical Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, The Netherlands
| | | | - Wiesje Maarse
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Maartje Sier
- Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands
- Department of Surgery, Rivierenland Hospital, Tiel, The Netherlands
| | | | | | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, The Netherlands
| | - Femke van der Leij
- Department of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, The Netherlands
| | - Annemiek Doeksen
- Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands
| | - Danny A Young-Afat
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Helena M Verkooijen
- Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Utrecht University, Utrecht, The Netherlands.
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20
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Dave RV, Elsberger B, Taxiarchi VP, Gandhi A, Kirwan CC, Kim B, Camacho EM, Coles CE, Copson E, Courtney A, Horgan K, Fairbrother P, Holcombe C, Kirkham JJ, Leff DR, McIntosh SA, O'Connell R, Pardo R, Potter S, Rattay T, Sharma N, Vidya R, Cutress RI. Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study. Breast Cancer Res Treat 2023; 199:265-279. [PMID: 37010651 PMCID: PMC10068712 DOI: 10.1007/s10549-023-06893-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/11/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources. METHODS This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb-July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis. RESULTS 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32-81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7-8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months' treatment duration; median of 4 mm [IQR - 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low (< 10%), with at least one month's duration of BrET. DISCUSSION This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.
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Affiliation(s)
- Rajiv V Dave
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK.
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oglesby Cancer Research Building, Manchester Cancer Research Centre, Wilmslow Road, Manchester, M20 4BX, UK.
| | - Beatrix Elsberger
- Aberdeen Royal Infirmary/University of Aberdeen, Breast Unit, Foresterhill Road, Aberdeen, AB25 2ZN, UK
| | - Vicky P Taxiarchi
- Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Ashu Gandhi
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oglesby Cancer Research Building, Manchester Cancer Research Centre, Wilmslow Road, Manchester, M20 4BX, UK
| | - Cliona C Kirwan
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oglesby Cancer Research Building, Manchester Cancer Research Centre, Wilmslow Road, Manchester, M20 4BX, UK
| | - Baek Kim
- Department of Breast Surgery, St. James's University Hospital, Leeds, LS9 7TF, UK
| | - Elizabeth M Camacho
- Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | | | - Ellen Copson
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Alona Courtney
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Kieran Horgan
- Department of Breast Surgery, St. James's University Hospital, Leeds, LS9 7TF, UK
| | | | - Chris Holcombe
- Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospital, Prescot Street, Liverpool, L7 8XP, UK
| | - Jamie J Kirkham
- Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Daniel R Leff
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Stuart A McIntosh
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Rachel O'Connell
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Ricardo Pardo
- Bolton NHS Foundation Trust, Minerva Rd, Farnworth, Bolton, BL4 0JR, UK
| | - Shelley Potter
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Canynge Hall, Whatley Road, Bristol, BS8 2PS, UK
- Bristol Breast Care Centre, North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK
| | - Tim Rattay
- Leicester Cancer Research Centre, Clinical Sciences Building, University of Leicester, Leicester, LE2 2LX, UK
| | - Nisha Sharma
- Breast Unit, Level 1 Chancellor Wing, St James's Hospital, Leeds, LS9 7TF, UK
| | - Raghavan Vidya
- The Royal Wolverhampton NHS Trust, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
| | - Ramsey I Cutress
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK
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Cancer stage and time from cancer diagnosis to first treatment during the COVID-19 pandemic. Semin Oncol 2023:S0093-7754(23)00038-6. [PMID: 37005143 PMCID: PMC10030331 DOI: 10.1053/j.seminoncol.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Introduction The COVID-19 pandemic has impacted cancer care and the diagnosis of new cases of cancer. We analyzed the impact of the COVID-19 pandemic on patients with cancer by comparing the number of newly diagnosed cases, cancer stage, and time to treatment in 2020 with those in 2018, 2019, and 2021. Methods A retrospective cohort of all cancer cases treated at A.C. Camargo Cancer Center in 2018–2021, identified from the Hospital Cancer Registry, was studied. We analyzed single and multiple primary cancer case and patient characteristics — by year and by clinical stage (early vs. advanced). Times from diagnosis to treatment were compared according to the most frequent tumor sites between 2020 and the other study years. Results Between 2018 and 2021, a total of 29,796 new cases were treated at the center including 24,891 with a single tumor and 4,905 with multiple tumors, including non-melanoma skin cancer. The number of new cases decreased by 25% between 2018 and 2020 and 22% between 2019 and 2020, followed by an increase of about 22% in 2021. Clinical stages differed across years, with the number of new advanced cases decreasing from 17.8% in 2018 to 15.2% in 2020. Diagnoses of advanced-stage for lung and kidney cancer decreased between 2018 and 2020, while the number of thyroid and prostate cancer cases diagnosed in advanced-stages increased from 2019 to 2020. The time from diagnosis to treatment decreased between 2018 and 2020 for breast (55.5 vs. 48 days), prostate (87 vs. 64 days), cervical/uterine (78 vs. 55 days) and oropharyngeal (50 vs. 28 days) cancers. Conclusion The COVID-19 pandemic affected the numbers of single and multiple cancers diagnosed in 2020. An increase in the number of advanced-stage cases diagnosed was observed only for thyroid and prostate cancer. This pattern may change in coming years due to the possibility that a significant number of cases went undiagnosed in 2020.
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22
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COVID-19 Adverse Outcomes in Immunocompromised Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2023. [DOI: 10.5812/ijcm-131077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a devastating viral pandemic infecting millions of people with a wide range of symptoms from fever to death. It has been suggested that immunocompromised patients are at a higher risk of severe disease, poor clinical outcomes, and mortality. However, these patients’ risk factors and COVID-19-related outcomes are not well characterized. Objectives: We evaluated the COVID-19-related outcomes among immunocompromised patients ranging from solid tumors, hematological malignancies, and HIV to autoimmune disease and transplant recipients who received immunosuppressive agents. We also aimed at finding risk factors related to mortality among immunocompromised patients with COVID-19. Methods: This cross-sectional study was conducted in Khansari Hospital, Iran between March and November 2021. We included immunocompromised patients with nasal swab positive SARS-CoV-2 polymerase chain reaction (PCR) results in the study. Patient outcomes, including hospitalization ward and the mortality rate, were assessed till three months after COVID-19 infection were evaluated in all patients. Moreover, the relation between risk factors and the rate of the mortality rate was analyzed in immunocompromised patients with COVID-19. Results: A total number of 74 immunocompromised patients with solid tumors, hematologic malignancies, autoimmune diseases, acquired immunodeficiencies, and solid-organ transplant recipients were included in the study. Results indicated that the male gender and ICU hospitalization significantly increase the mortality risk. Surprisingly, chemotherapy is associated with a lower risk of mortality. Conclusions: Identifying the risk factors can improve the decision-making on cancer patients’ management during the COVID-19 infection. A further large cohort of patients would be required to identify risk factors relating to poor clinical outcomes and mortality rates in immunocompromised patients with COVID-19.
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23
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Bochicchio I, La Rosa VL, Marino G, Craparo G, Commodari E, Deiana G, Sanseverino F, Tartarone A, Conca R, Lettini AR. Psychological Well-Being of Cancer Patients before and during the Pandemic: The Impact of COVID-19 Peritraumatic Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4106. [PMID: 36901117 PMCID: PMC10002171 DOI: 10.3390/ijerph20054106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study aimed to evaluate the psychological impact of the COVID-19 pandemic on cancer patients. METHODS Ninety cancer patients undergoing chemotherapy with antiblastics were recruited from a tertiary medical center and completed a battery of standardized questionnaires to assess anxiety, depression, peritraumatic stress, and quality of life before and during the pandemic. RESULTS Quality of life worsened significantly during the pandemic compared with the pre-pandemic period. Anxiety and depression levels also increased significantly during the pandemic. COVID-19 peritraumatic distress significantly predicted lower quality-of-life scores during the pandemic. CONCLUSIONS COVID-19 distress affected the overall quality of life of patients who already had lower levels of quality of life before the pandemic and who had advanced cancers. Cancer patients must receive adequate support from psychiatrists and psychologists to mitigate the psychological distress related to the pandemic.
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Affiliation(s)
- Ilaria Bochicchio
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | | | - Graziella Marino
- Unit of Breast Surgery, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Giovanni Deiana
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Francesca Sanseverino
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Alfredo Tartarone
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Raffaele Conca
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Alessandro Rocco Lettini
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
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Tolia M, Symvoulakis EK, Matalliotakis E, Kamekis A, Adamou M, Kountourakis P, Mauri D, Dakanalis A, Alexidis P, Varveris A, Antoniadis C, Matthaios D, Paraskeva M, Giaginis C, Kamposioras K. COVID-19 Emotional and Mental Impact on Cancer Patients Receiving Radiotherapy: An Interpretation of Potential Explaining Descriptors. Curr Oncol 2023; 30:586-597. [PMID: 36661695 PMCID: PMC9857784 DOI: 10.3390/curroncol30010046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Background: Significant changes in the accessibility and viability of health services have been observed during the COVID-19 period, particularly in vulnerable groups such as cancer patients. In this study, we described the impact of radical practice and perceived changes on cancer patients’ mental well-being and investigated potential outcome descriptors. Methods: Generalized anxiety disorder assessment (GAD-7), patient health (PHQ-9), and World Health Organization-five well-being index (WHO-5) questionnaires were used to assess anxiety, depression, and mental well-being. Information on participants, disease baseline information, and COVID-19-related questions were collected, and related explanatory variables were included for statistical analysis. Results: The mean score values for anxiety, depression, and mental well-being were 4.7 ± 5.53, 4.9 ± 6.42, and 72.2 ± 18.53, respectively. GAD-7 and PHQ-9 scores were statistically associated (p < 0.001), while high values of GAD-7 and PHQ-9 questionnaires were related to low values of WHO-5 (p < 0.001).Using the GAD-7 scale, 16.2% of participants were classified as having mild anxiety (GAD-7 score: 5−9).Mild to more severe anxiety was significantly associated with a history of mental health conditions (p = 0.01, OR = 3.74, 95% CI [1.372−10.21]), and stage category (stage III/IV vs. I/II, p = 0.01, OR = 3.83, 95% CI [1.38−10.64]. From the participants, 36.2% were considered to have depression (PHQ-9 score ≥ 5). Depression was related with older patients (p = 0.05, OR = 1.63, 95% CI [1.16−2.3]), those with previous mental health conditions (p = 0.03, OR = 14.24, 95% CI [2.47−81.84]), those concerned about the COVID-19 impact on their cancer treatment (p = 0.027, OR = 0.19, 95% CI [0.045−0.82]) or those who felt that COVID-19 pandemic has affected mental health (p = 0.013, OR = 3.56, 95% CI [1.30−9.72]). Additionally, most participants (86.7%) had a good well-being score (WHO-5 score ≥ 50). Mental well-being seemed more reduced among stage I−III patients than stage IV patients (p = 0.014, OR = 0.12, 95% CI [0.023−0.65]). Conclusion: There is a necessity for comprehensive cancer care improvement. These patients’ main concern related to cancer therapy, yet the group of patients who were mentally affected by the pandemic should be identified and supported.
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Affiliation(s)
- Maria Tolia
- Department of Radiation Oncology, School of Medicine, University of Crete, 71300 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71300 Heraklion, Greece
| | - Emmanouil Matalliotakis
- Department of Radiation Oncology, School of Medicine, University of Crete, 71300 Heraklion, Greece
| | | | - Marios Adamou
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
| | | | - Davide Mauri
- Medical Oncology, University of Ioannina, 45500 Ioannina, Greece
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Petros Alexidis
- Department of Radiation Oncology, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Antonios Varveris
- Department of Radiation Oncology, School of Medicine, University of Crete, 71300 Heraklion, Greece
| | - Chrysostomos Antoniadis
- Department of Radiation Oncology, School of Medicine, University of Crete, 71300 Heraklion, Greece
| | | | - Maria Paraskeva
- Oncology Department, General Hospital of Rhodes, 85133 Rhodes, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece
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25
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Kaiser U, Vehling-Kaiser U, Schmidt J, Hoffmann A, Kaiser F. Consequences of the Corona crisis on outpatient oncological care - a qualitative study among nurses and medical assistants. PLoS One 2022; 17:e0276573. [PMID: 36269784 PMCID: PMC9586350 DOI: 10.1371/journal.pone.0276573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The Covid-19 pandemic has caused great personal stress for medical staff. To ensure adequate outpatient care for cancer patients, extensive safety and hygiene measures must be taken. This interview-based study examines the effects–both personal and professional–of the pandemic on the work routine of outpatient hematology/oncology nurses and medical assistants. Patients, materials and methods Half a year after the outbreak of Covid-19 and the introduction of infection control regulations in three outpatient hematological/oncological centers, the affected medical staff (n = 15) were surveyed about the consequences for patient care and clinical work using audio-recorded telephone interviews. The interviews were transcribed and analyzed using a qualitative content analysis. Results The Covid-19 pandemic has complicated the medical care of cancer patients, but only a slight deterioration of medical and psycho-oncological care was observed. The level of stress experienced by medical staff is moderate, with hygiene and safety measures at the workplace helping to reduce stress. Conclusion From the point of view of medical staff, the Covid-19 pandemic has had a moderate impact on the outpatient care of cancer patients. Safety measures against Covid-19 are decisive for ensuring the continuation of therapy and for motivating employees.
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Affiliation(s)
- Ulrich Kaiser
- Clinic and Polyclinic for Internal Medicine III, Regensburg University Hospital, Regensburg, Bavaria, Germany
- * E-mail:
| | | | - Jörg Schmidt
- Institute for Market Research in the Health Care System Munich, Munich, Bavaria, Germany
| | - Ana Hoffmann
- VK&K Studien GbR Landshut, Landshut, Bavaria, Germany
| | - Florian Kaiser
- Oncological-Palliative Network Landshut, Landshut, Bavaria, Germany
- Clinic for Hematology and Medical Oncology, University Medical Centre Göttingen, Göttingen, Lower Saxon, Germany
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Zarkar A, Pirrie S, Stubbs C, Hodgkins AM, Farrugia D, Fife K, MacDonald-Smith C, Vasudev N, Porfiri E. A Study of Pazopanib Safety and Efficacy in Patients With Advanced Clear Cell Renal Cell Carcinoma and ECOG Performance Status 2 (Pazo2): An Open label, Multicentre, Single Arm, Phase II Trial. Clin Genitourin Cancer 2022; 20:473-481. [PMID: 35803859 DOI: 10.1016/j.clgc.2022.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
AIM Patients with advanced renal cell carcinoma and poor performance status (PS≥2) are often deemed unsuitable for treatment. The Pazo2 trial aimed to assess tolerability and efficacy of pazopanib as first-line treatment in renal cancer patients with ECOG PS2. METHODS Pazo2 was a prospective, single arm, open label, multicentre, phase II trial, conducted in 26 UK centres. Eligible patients were aged ≥18 years, with advanced or metastatic renal cancer and a clear cell component (aRCC), measurable disease as per RECIST Criteria 1.1, and ECOG PS2. Co-primary outcomes, assessed at 6-months after patients entered the trial, were tolerability, defined as the proportion of patients who did not develop "intolerable" adverse events, and efficacy, defined as the proportion of all patients who were progression-free and alive. RESULTS Between February 21, 2013 and August 12, 2016, 75 patients were registered. Median age was 68.6 years (IQR 64.6-76.0), 100% ECOG PS2, 62.7% 'poor risk' (International Metastatic Renal-Cell Carcinoma Database Consortium). Of the 65 evaluable patients, 70.8% (95% CI: 58.8, 80.4) did not develop "intolerable" adverse events and 56.9% (95% CI: 44.8, 68.2) were still alive and progression-free 6 months after starting pazopanib. Twenty-seven patients developed serious adverse events deemed to be related to pazopanib. CONCLUSION These data suggests that pazopanib is tolerated and effective in aRCC patients with PS2 and represents a treatment option for patients who cannot receive or tolerate immune checkpoint inhibitors.
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Affiliation(s)
- Anjali Zarkar
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Sarah Pirrie
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, United Kingdom.
| | - Clive Stubbs
- Birmingham Clinical Trials Unit (BCTU), University of Birmingham, Birmingham, United Kingdom
| | - Anne-Marie Hodgkins
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, United Kingdom
| | | | - Kathryn Fife
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | | | - Emilio Porfiri
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
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Rucinska M, Nawrocki S. COVID-19 Pandemic: Impact on Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12470. [PMID: 36231769 PMCID: PMC9564768 DOI: 10.3390/ijerph191912470] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
In December 2019, there were first reports of an atypical pneumonia detected in Wuhan city, China [...]
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Affiliation(s)
- Monika Rucinska
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-228 Olsztyn, Poland
| | - Sergiusz Nawrocki
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-228 Olsztyn, Poland
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Di Cosimo S, Susca N, Apolone G, Silvestris N, Racanelli V. The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic. Front Oncol 2022; 12:961380. [PMID: 36249038 PMCID: PMC9556993 DOI: 10.3389/fonc.2022.961380] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/12/2022] [Indexed: 01/19/2023] Open
Abstract
Background The rapid and global spread of COVID-19 posed a massive challenge to healthcare systems, which came across the need to provide high-intensity assistance to thousands of patients suffering from SARS-CoV-2 infection while assuring continuous care for all other diseases. This has been of particular importance in the oncology field. This study explores how oncology centers responded to the pandemic at a single center level by assessing surveys addressing different aspects of cancer care after the pandemic outbreak. Methods We performed a systematic review and meta-analysis of the cancer care surveys published until December 11th, 2020. Data were analyzed according to three main areas of interest, namely health care organization, including cancellation/delay and/or modification of scheduled treatments, cancellation/delay of outpatient visits, and reduction of overall cancer care activities; routine use of preventive measures, such as personal protective equipment (PPE) by both patients and health care workers, and systematic SARS-CoV-2 screening by nasopharyngeal swabs; and implementation of telemedicine through remote consultations. Findings Fifty surveys reporting data on 9150 providers from 121 countries on 5 continents were included. Cancellation/delay of treatment occurred in 58% of centers; delay of outpatient visits in 75%; changes in treatment plans in 65%; and a general reduction in clinical activity in 58%. Routine use of PPE by patients and healthcare personnel was reported by 81% and 80% of centers, respectively; systematic SARS-CoV-2 screening by nasopharyngeal swabs was reported by only 41% of centers. Virtual visits were implemented by the majority (72%) of centers. Interpretation These results describe the negative impact of COVID-19 on cancer care, the rapid response of cancer centers in terms of preventive measures and alternative treatment approaches such as telemedicine, and confirm that surveys can provide the valuable, low-cost and immediate information that critical situations require.
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Affiliation(s)
- Serena Di Cosimo
- Platform of Integrated Biology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Susca
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Vito Racanelli
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
- *Correspondence: Vito Racanelli,
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Nascimento AADA, Torres DVDO, Silva AFMD, Rocha MCDS, Silva AFD, Azevedo ICD. Onco-hematological patient care in times of COVID-19: a scoping review. Rev Bras Enferm 2022; 75Suppl 2:e20210892. [PMID: 36134783 DOI: 10.1590/0034-7167-2021-0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/16/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to identify and map health care aimed at onco-hematological patients in times of Coronavirus 2019. METHODS this is a scoping review, anchored in the Joanna Briggs Institute theoretical framework, registered in the Open Science Framework, with searches carried out in June 2021, through searches in the databases. RESULTS a final sample consisting of 20 articles was obtained, with emphasis on general care, treatment and stem cell donation. The most reported care was the use of telemedicine, screening for Coronavirus Disease 2019, compliance with prevention practices and, in case of infection, postponing procedures. CONCLUSIONS the study gathered the main evidence on care aimed at treating these patients in times of a pandemic. Such measures help in the clinical management with the objective of proceeding with treatment amidst the injuries caused, thus minimizing possible complications.
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Stanizzo MR, Castelli L, Di Nardo C, Brunetti M, De Sanctis C, Ghiggia A. Psychological Distress in Breast Cancer Patients during the Italian COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11433. [PMID: 36141706 PMCID: PMC9517421 DOI: 10.3390/ijerph191811433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The emergency caused by the SARS-CoV-2 pandemic exacerbated psychological distress. Our aim was to investigate the impact of breast cancer on patients' lives during the Italian lockdown. METHODS Sixty-five female breast cancer patients were studied, assessing the level of psychological distress with the Hospital Anxiety and Depression Scale (HADS) and the impact of the cancer diagnosis (Impact of Event Scale-Revised-IES-R). In addition, we compared these data with a matched group of breast cancer patients enrolled in 2019. RESULTS Patients enrolled in 2020 had statistically higher levels of anxious symptomatology and higher levels of traumatic symptomatology due to the cancer diagnosis. A mediation analysis was performed to determine how the experience of distress due to COVID-19 negatively impacted the level of anxiety and amplified the impact of the diagnosis with a significant increase in traumatic symptoms. CONCLUSIONS Considering the vulnerability of these patients and the serious and novel situation that the healthcare system is currently facing, we would like to point out the importance of structured and organised psychological support for these patients.
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Affiliation(s)
- Maria Rosa Stanizzo
- Breast Unit, Department of Gynecology and Obstetrics, AOU Città della Salute e della Scienza, 10126 Turin, Italy
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, 10126 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Cristina Di Nardo
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, 10126 Turin, Italy
| | - Monica Brunetti
- Breast Unit, Department of Gynecology and Obstetrics, AOU Città della Salute e della Scienza, 10126 Turin, Italy
| | - Corrado De Sanctis
- Breast Unit, Department of Gynecology and Obstetrics, AOU Città della Salute e della Scienza, 10126 Turin, Italy
| | - Ada Ghiggia
- Department of Life Sciences, University of Trieste, 34128 Trieste, Italy
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Freeman V, Hughes S, Carle C, Campbell D, Egger S, Hui H, Yap S, Deandrea S, Caruana M, Onyeka TC, IJzerman MJ, Ginsburg O, Bray F, Sullivan R, Aggarwal A, Peacock SJ, Chan KKW, Hanna TP, Soerjomataram I, O'Connell DL, Steinberg J, Canfell K. Are patients with cancer at higher risk of COVID-19-related death? A systematic review and critical appraisal of the early evidence. J Cancer Policy 2022; 33:100340. [PMID: 35680113 PMCID: PMC9169424 DOI: 10.1016/j.jcpo.2022.100340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early reports suggested that COVID-19 patients with cancer were at higher risk of COVID-19-related death. We conducted a systematic review with risk of bias assessment and synthesis of the early evidence on the risk of COVID-19-related death for COVID-19 patients with and without cancer. METHODS AND FINDINGS We searched Medline/Embase/BioRxiv/MedRxiv/SSRN databases to 1 July 2020. We included cohort or case-control studies published in English that reported on the risk of dying after developing COVID-19 for people with a pre-existing diagnosis of any cancer, lung cancer, or haematological cancers. We assessed risk of bias using tools adapted from the Newcastle-Ottawa Scale. We used the generic inverse-variance random-effects method for meta-analysis. Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated separately. Of 96 included studies, 54 had sufficient non-overlapping data to be included in meta-analyses (>500,000 people with COVID-19, >8000 with cancer; 52 studies of any cancer, three of lung and six of haematological cancers). All studies had high risk of bias. Accounting for at least age consistently led to lower estimated ORs and HRs for COVID-19-related death in cancer patients (e.g. any cancer versus no cancer; six studies, unadjusted OR=3.30,95%CI:2.59-4.20, adjusted OR=1.37,95%CI:1.16-1.61). Adjusted effect estimates were not reported for people with lung or haematological cancers. Of 18 studies that adjusted for at least age, 17 reported positive associations between pre-existing cancer diagnosis and COVID-19-related death (e.g. any cancer versus no cancer; nine studies, adjusted OR=1.66,95%CI:1.33-2.08; five studies, adjusted HR=1.19,95%CI:1.02-1.38). CONCLUSIONS The initial evidence (published to 1 July 2020) on COVID-19-related death in people with cancer is characterised by multiple sources of bias and substantial overlap between data included in different studies. Pooled analyses of non-overlapping early data with adjustment for at least age indicated a significantly increased risk of COVID-19-related death for those with a pre-existing cancer diagnosis.
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Affiliation(s)
- Victoria Freeman
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Chelsea Carle
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Denise Campbell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Sarsha Yap
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Silvia Deandrea
- Directorate General for Health, Lombardy Region, Milano, Italy; Environmental Health Unit, Agency for Health Protection, Pavia, Italy
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain & Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Nigeria
| | - Maarten J IJzerman
- University of Melbourne, Centre for Cancer Research and Centre for Health Policy, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Ophira Ginsburg
- Perlmutter Cancer Center and the Department of Population Health, NYU Grossman School of Medicine, New York, United States
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Richard Sullivan
- King's Institute Cancer Policy, King's College London, United Kingdom
| | - Ajay Aggarwal
- King's Institute Cancer Policy, King's College London, United Kingdom; Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Peacock
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, BC Cancer, Canada; Faculty of Health Sciences, Simon Fraser University, Canada
| | - Kelvin K W Chan
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, Kingston, ON, Canada; Department of Oncology and Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia.
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia.
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Carle C, Hughes S, Freeman V, Campbell D, Egger S, Caruana M, Hui H, Yap S, Deandrea S, Onyeka TC, IJzerman MJ, Ginsburg O, Bray F, Sullivan R, Aggarwal A, Peacock SJ, Chan KKW, Hanna TP, Soerjomataram I, O'Connell DL, Canfell K, Steinberg J. The risk of contracting SARS-CoV-2 or developing COVID-19 for people with cancer: A systematic review of the early evidence. J Cancer Policy 2022; 33:100338. [PMID: 35671919 PMCID: PMC9167683 DOI: 10.1016/j.jcpo.2022.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The early COVID-19 literature suggested that people with cancer may be more likely to be infected with SARS-CoV-2 or develop COVID-19 than people without cancer, due to increased health services contact and/or immunocompromise. While some studies were criticised due to small patient numbers and methodological limitations, they created or reinforced concerns of clinicians and people with cancer. These risks are also important in COVID-19 vaccine prioritisation decisions. We performed a systematic review to critically assess and summarise the early literature. METHODS AND FINDINGS We conducted a systematic search of Medline/Embase/BioRxiv/MedRxiv/SSRN databases including peer-reviewed journal articles, letters/commentaries, and non-peer-reviewed pre-print articles for 1 January-1 July 2020. The primary endpoints were diagnosis of COVID-19 and positive SARS-CoV-2 test. We assessed risk of bias using a tool adapted from the Newcastle-Ottawa Scale. Twelve studies were included in the quantitative synthesis. All four studies of COVID-19 incidence (including 24,181,727 individuals, 125,649 with pre-existing cancer) reported that people with cancer had higher COVID-19 incidence rates. Eight studies reported SARS-CoV-2 test positivity for > 472,000 individuals, 48,370 with pre-existing cancer. Seven of these studies comparing people with any and without cancer, were pooled using random effects [pooled odds ratio 0.91, 95 %CI: 0.57-1.47; unadjusted for age, sex, or comorbidities]. Two studies suggested people with active or haematological cancer had lower risk of a positive test. All 12 studies had high risk of bias; none included universal or random COVID-19/SARS-CoV-2 testing. CONCLUSIONS The early literature on susceptibility to SARS-CoV-2/COVID-19 for people with cancer is characterised by pervasive biases and limited data. To provide high-quality evidence to inform decision-making, studies of risk of SARS-CoV-2/COVID-19 for people with cancer should control for other potential modifiers of infection risk, including age, sex, comorbidities, exposure to the virus, protective measures taken, and vaccination, in addition to stratifying analyses by cancer type, stage at diagnosis, and treatment received.
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Affiliation(s)
- Chelsea Carle
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Victoria Freeman
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Denise Campbell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Sarsha Yap
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Silvia Deandrea
- Directorate General for Health, Lombardy Region, Milano, Italy; Environmental Health Unit, Agency for Health Protection, Pavia, Italy
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain & Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Nigeria
| | - Maarten J IJzerman
- University of Melbourne, Centre for Cancer Research and Centre for Health Policy, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Ophira Ginsburg
- Perlmutter Cancer Center and the Department of Population Health, NYU Grossman School of Medicine, New York, United States
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Richard Sullivan
- King's Institute of Cancer Policy, King's College, London, United Kingdom
| | - Ajay Aggarwal
- King's Institute of Cancer Policy, King's College, London, United Kingdom; Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Peacock
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, BC Cancer, Canada; Faculty of Health Sciences, Simon Fraser University, Canada
| | - Kelvin K W Chan
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, Kingston, ON, Canada; Department of Oncology and Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia.
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Australia.
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Hassan AM, Chu CK, Liu J, Angove R, Rocque G, Gallagher KD, Momoh AO, Caston NE, Williams CP, Wheeler S, Butler CE, Offodile AC. Determinants of telemedicine adoption among financially distressed patients with cancer during the COVID-19 pandemic: insights from a nationwide study. Support Care Cancer 2022; 30:7665-7678. [PMID: 35689108 PMCID: PMC9187333 DOI: 10.1007/s00520-022-07204-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/03/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Telemedicine use during the COVID-19 pandemic among financially distressed patients with cancer, with respect to the determinants of adoption and patterns of utilization, has yet to be delineated. We sought to systematically characterize telemedicine utilization in financially distressed patients with cancer during the COVID-19 pandemic. METHODS We conducted a cross-sectional analysis of nationwide survey data assessing telemedicine use in patients with cancer during the COVID-19 pandemic collected by Patient Advocate Foundation (PAF) in December 2020. Patients were characterized as financially distressed by self-reporting limited financial resources to manage out-of-pocket costs, psychological distress, and/or adaptive coping behaviors. Primary study outcome was telemedicine utilization during the pandemic. Secondary outcomes were telemedicine utilization volume and modality preferences. Multivariable and Poisson regression analyses were used to identify factors associated with telemedicine use. RESULTS A convenience sample of 627 patients with cancer responded to the PAF survey. Telemedicine adoption during the pandemic was reported by 67% of patients, with most (63%) preferring video visits. Younger age (19-35 age compared to ≥ 75 age) (OR, 6.07; 95% CI, 1.47-25.1) and more comorbidities (≥ 3 comorbidities compared to cancer only) (OR, 1.79; 95% CI, 1.13-2.65) were factors associated with telemedicine adoption. Younger age (19-35 years) (incidence rate ratios [IRR], 1.78; 95% CI, 24-115%) and higher comorbidities (≥ 3) (IRR; 1.36; 95% CI, 20-55%) were factors associated with higher utilization volume. As area deprivation index increased by 10 units, the number of visits decreased by 3% (IRR 1.03, 95% CI, 1.03-1.05). CONCLUSIONS The rapid adoption of telemedicine may exacerbate existing inequities, particularly among vulnerable financially distressed patients with cancer. Policy-level interventions are needed for the equitable and efficient provision of this service.
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Affiliation(s)
- Abbas M Hassan
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Carrie K Chu
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Jun Liu
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | | | - Gabrielle Rocque
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Adeyiza O Momoh
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Nicole E Caston
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephanie Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles E Butler
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Anaeze C Offodile
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA.
- Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Baker Institute for Public Policy, Rice University, Houston, TX, USA.
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Venkataramany BS, Sutton JM. The Importance of Social Determinants of Health for Cancer Patients in the Era of COVID-19. Cureus 2022; 14:e27993. [PMID: 36120243 PMCID: PMC9469753 DOI: 10.7759/cureus.27993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has proven to be a challenge for public health professionals, researchers, clinicians, and patients. One group that has experienced significant difficulties during this time is cancer patients. Data regarding this vulnerable population is scarce, despite novel information about vaccine efficacy, therapeutics, mutations, and comorbidities. In this article, we discuss the need for a greater study of social determinants of health (SDOH) for cancer patients in the context of the COVID-19 pandemic. The effects of SDOH on population health are generally well-understood, but their effects on cancer patients are poorly understood. We further pose questions that may be starting points for the investigation of SDOH in cancer patients during this time. Using SDOH as a tool for more effective clinical care will promote the development of targeted interventions to study and improve outcomes in this population.
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Kourtidis S, Münst J, Hofmann VM. Effects of the COVID-19 Pandemic on Head and Neck Cancer Stage and Treatment Duration. Cureus 2022; 14:e26744. [PMID: 35967177 PMCID: PMC9364957 DOI: 10.7759/cureus.26744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To assess the efficacy of oncologic healthcare during the COVID-19 pandemic on patients with head and neck squamous cell carcinoma (SCC) in a tertiary university hospital in Germany. Methods This retrospective, cross-sectional, observational study included 94 patients with newly diagnosed head and neck squamous cell carcinoma during a two-year period. Patients were assigned to two date-dependent groups; referrals before (group A) and during (group B) the COVID-19 pandemic. Time intervals from the symptom(s) onset to diagnosis, diagnosis to treatment, and treatment initiation to completion were recorded. Furthermore, TNM stages and the application of reconstructive surgery with free tissue transfer were determined. Patients’ outcomes and characteristics were compared between the two groups. Finally, a comprehensive literature review was carried out to identify similar epidemiological studies. Results The symptom-to-diagnosis interval was longer during the COVID-19 pandemic [median 9.5 (A) versus 15 (B) weeks, p = 0.054]. The intervals from diagnosis to treatment and treatment initiation to end of treatment were approximately the same in both groups [median 3 (A) versus 3.2 (B) weeks, p = 0.264; and 6.9 (A) versus 6.3 (B) weeks, p = 0.136]. The T-and N-stages were not higher during the pandemic [early T-stage (T1+T2) versus advanced T-stage (T3+T4), p = 0.668; and N-negative (N0) versus N-positive status (N1,2,3), p = 0.301]. Patients who presented with distant metastatic disease and those who underwent reconstructive surgery with free tissue transfer were observed more frequently in the lockdown phase [M1 versus M0, p= 0.022; and flap versus no flap, p=0.007]. Conclusion This study suggests the consistent diagnostic and therapeutical performance of the tertiary oncologic healthcare in Berlin, Germany, despite the challenges that patient care units faced during the COVID-19 pandemic.
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Zou J, Xiao Z, Yang J, Li L, Hao T, Cui N, Wu J, Wu Y. Impact of cancer types on COVID-19 infection and mortality risk: a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e058078. [PMID: 35803638 PMCID: PMC9271838 DOI: 10.1136/bmjopen-2021-058078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has created a huge social and economic burden, and the lifestyles of individuals have significantly changed. In addition, the diagnosis, treatment and management of patients with cancer were greatly affected. Studies have shown that patients with cancer are at a higher risk of COVID-19 infection-related complications, which require aggressive preventive measures. Different types of cancer may have different risks of COVID-19 infection and death, and different preventive care measures are needed for different types of patients with cancer. Here, we designed a protocol for systematic review and meta-analysis to explore the impact of cancer types on COVID-19 infection and mortality risk. METHODS AND ANALYSIS A systematic search plan will be performed to filter the eligible studies in the seven databases, namely PubMed, Cochrane search strategy, EMBASE search strategy, SinoMed, China National Knowledge Infrastructure, China Science and Technology Journals Database, and Wanfang database from 2019 to 10 August 2021. Two independent reviewers will choose the eligible studies and extract the data. The risk of bias will be evaluated based on the Newcastle-Ottawa Scale recommended by the Cochrane Collaboration. Finally, a systematic review and meta-analysis will be performed using Review Manager (V.5.3) statistical software. ETHICS AND DISSEMINATION Formal ethical approval is not required, and the findings will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021271108.
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Affiliation(s)
- Jianhua Zou
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Zhanshuo Xiao
- China Academy of Chinese Medical Sciences Guanganmen Hospital, Beijing, China
| | - Jingyan Yang
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Liusheng Li
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Tengteng Hao
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Ning Cui
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Jiao Wu
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Yu Wu
- China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
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Belciug S. Learning deep neural networks' architectures using differential evolution. Case study: Medical imaging processing. Comput Biol Med 2022; 146:105623. [PMID: 35751202 PMCID: PMC9112664 DOI: 10.1016/j.compbiomed.2022.105623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/03/2022] [Accepted: 03/31/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has changed the way we practice medicine. Cancer patient and obstetric care landscapes have been distorted. Delaying cancer diagnosis or maternal-fetal monitoring increased the number of preventable deaths or pregnancy complications. One solution is using Artificial Intelligence to help the medical personnel establish the diagnosis in a faster and more accurate manner. Deep learning is the state-of-the-art solution for image classification. Researchers manually design the structure of fix deep learning neural networks structures and afterwards verify their performance. The goal of this paper is to propose a potential method for learning deep network architectures automatically. As the number of networks architectures increases exponentially with the number of convolutional layers in the network, we propose a differential evolution algorithm to traverse the search space. At first, we propose a way to encode the network structure as a candidate solution of fixed-length integer array, followed by the initialization of differential evolution method. A set of random individuals is generated, followed by mutation, recombination, and selection. At each generation the individuals with the poorest loss values are eliminated and replaced with more competitive individuals. The model has been tested on three cancer datasets containing MRI scans and histopathological images and two maternal-fetal screening ultrasound images. The novel proposed method has been compared and statistically benchmarked to four state-of-the-art deep learning networks: VGG16, ResNet50, Inception V3, and DenseNet169. The experimental results showed that the model is competitive to other state-of-the-art models, obtaining accuracies between 78.73% and 99.50% depending on the dataset it had been applied on.
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Silvestris N, Belleudi V, Addis A, Pimpinelli F, Morrone A, Sciacchitano S, Mancini R, Garrisi VM, Costantini M, Ciliberto G, Frisardi V, Piaggio G. Development of Approaches and Metrics to Measure the Impact and Improve the Clinical Outcomes of Patients With Frailty in the Era of COVID-19. The COMETA Italian Protocol. Front Oncol 2022; 12:828660. [PMID: 35756683 PMCID: PMC9215159 DOI: 10.3389/fonc.2022.828660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
The outbreak of the coronavirus 2 disease 2019 (COVID-19) puts an enormous burden on healthcare systems worldwide. This may worsen outcomes in patients with severe chronic diseases such as cancer, autoimmune diseases, and immune deficiencies. In this critical situation, only a few available data exist, which do not allow us to provide practical guides for the treatment of oncological or immunocompromised patients. Therefore, a further step forward is needed, addressing the specific needs and demands of frail patients in the pandemic era. Here we aim to present a protocol of a study approved by an ethical committee named "CO.M.E.TA". CO.M.E.TA protocol is a network project involving six Italian institutions and its goals are: i) to measure and compare the impact of the pandemic on the access of cancer and immunocompromised patients to therapies in three Italian regions; ii) to assess how reorganizational measures put in place in these different institutions have impacted specific metrics of performance; iii) to establish a COVID-19 Biobank of biological samples from SARS-CoV-2 infected patients to be used to study immunological alterations in patients with immune frailty.
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Affiliation(s)
- Nicola Silvestris
- Istituto Tumori "Giovanni Paolo II" of Bari, IRCCS, Bari, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | | | - Aldo Morrone
- San Gallicano Dermatological Institute, IRCCS, Roma, Italy
| | | | - Rita Mancini
- Azienda Ospedaliera Universitaria Sant'Andrea, Sapienza University, Roma, Italy
| | | | - Massimo Costantini
- Geriatric Unit, Azienda Unità Sanitaria Locale (AUSL), IRCCS, Reggio Emilia, Italy
| | | | - Vincenza Frisardi
- Geriatric Unit, Azienda Unità Sanitaria Locale (AUSL), IRCCS, Reggio Emilia, Italy
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Silvestri G, Borgese C, Sommacal S, Iannopollo L, Cristaldi G, Serpentini S. The Role of the Psycho-Oncologist during the COVID-19 Pandemic: A Clinical Breast Cancer Case Report. Behav Sci (Basel) 2022; 12:bs12070211. [PMID: 35877281 PMCID: PMC9312069 DOI: 10.3390/bs12070211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
The 2019 coronavirus pandemic (COVID-19) has been very stressful, but more so for those with cancer. Patients with cancer experienced more pandemic-related stress and psychological distress than those without a cancer diagnosis. This case report, about a breast cancer patient, is presented in order to emphasize (1) the importance of the management of psychological care in oncology, (2) the need for a thorough understanding of the efficacy of the role of the psycho-oncologist and related interventions in a breast care unit for the health of both patients and professionals to improve clinical outcomes, and (3) the emerging health concerns of breast cancer patients in the context of the COVID-19 pandemic.
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Brynskog E, Larsson M, Bjuresäter K, Rosell L, Smith F. Altered prerequisites: A cross-sectional survey regarding cancer care in Sweden during COVID-19 from the viewpoint of contact nurses in cancer care. NORDIC JOURNAL OF NURSING RESEARCH 2022. [PMCID: PMC9204122 DOI: 10.1177/20571585221101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Contact nurses in cancer care were vital in sustaining cancer care in Sweden during the COVID-19 pandemic. The aim of this study was to investigate their experiences of providing care to people with cancer in these exceptional circumstances to identify emerging challenges and opportunities that must be addressed moving forward. A survey distributed to contact nurses was supplemented with questions regarding the pandemic. The study design was a cross-sectional survey, analyzed with descriptive statistics and content analysis, reported in accordance with STROBE. Almost half of respondents ( n = 337) reported not being able to provide the same support as before the pandemic. Analysis of open-ended question responses ( n = 232) revealed a main theme: Altered prerequisites for providing care. Three categories related to altered interaction, accessibility, and nursing reality were revealed. Thorough reflection is needed to make use of lessons learned and avoid sustaining the short-term solutions needed to cope with the acute phase of the pandemic.
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Affiliation(s)
| | - Maria Larsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Kaisa Bjuresäter
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Linn Rosell
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Regional Cancer Centre South, Lund, Sweden
| | - Frida Smith
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden and Regional Cancer Centre West, Gothenburg, Sweden
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Chiruvella V, Ullah A, Elhelf I, Patel N, Karim NA. Would the Addition of Immunotherapy Impact the Prognosis of Patients With Malignant Pericardial Effusion? Front Oncol 2022; 12:871132. [PMID: 35600364 PMCID: PMC9120828 DOI: 10.3389/fonc.2022.871132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
Pericardial effusion is a common finding in advanced-stage lung cancer. The presence of malignant cells or drainage of exudate effusion in the pericardial space may cause symptoms of dyspnea, pleuritic chest pain, and syncope. In addition to the difficulty physicians face in the detection and diagnosis of malignant pericardial effusion, treatment may be challenging considering the cancer prognosis and cardiovascular stability of the patient. Despite the availability of several treatment modalities for malignant pericardial effusion, including chemotherapy and surgery, patients with lung cancer historically present with poor prognoses. In addition to lung adenocarcinoma with malignant pericardial effusion, this case was complicated by COVID-19 and malignancy-associated obstructive pneumonia. We present a case of a 64-year-old woman with advanced non-small cell lung carcinoma (NSCLC) with malignant pericardial effusion who, despite testing positive for COVID-19 and having obstructive pneumonia, had favorable outcomes following systemic therapy with combined chemo-immunotherapy.
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Della Vecchia C, Girodet M, Ginguené S, Carpentier C, Leroy T, Siméone A, Vayre E, Mabire X, Ferraz D, Morin-Messabel C, Préau M. At the heart of the COVID-19 crisis: Perceived concerns of changes in long-term cancer care in French women with cancer. Eur J Cancer Care (Engl) 2022; 31:e13599. [PMID: 35523418 PMCID: PMC9349365 DOI: 10.1111/ecc.13599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022]
Abstract
Objective In the COVID‐19 crisis context, the main objective of the study is to investigate factors associated with perceived concerns of change in long‐term cancer care in patients currently under treatment. Methods A French population‐based cross‐sectional study was performed using an online questionnaire in April 2020. All persons currently receiving cancer treatment and belonging to the Seintinelles Association (https://www.seintinelles.com) were included in this present analysis. Individual sociodemographic characteristics, medical status and information regarding cancer care were collected. Multivariate binomial logistic regression analysis was performed. Results We included 298 women in the analysis. Younger participants (OR = 0.96 [0.94–0.99]), the need to visit healthcare facilities to receive treatment (OR = 2.93 [1.16–8.52]), deterioration in the quality of communication with the medical team since the beginning of the COVID‐19 crisis (OR = 3.24 [1.61–7.02]) and being cared for by a university hospital or a public hospital (OR = 2.19 [1.16–4.23] versus comprehensive cancer centre) were associated with a perceived fear of change in long‐term cancer care. Conclusion To address patients' concerns regarding changes in their long‐term cancer care, medical teams should consider the patients' own perceptions of the situation and provide clear, appropriate, precise information on cancer care, especially in the centres mostly affected by the COVID‐19 crisis.
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Affiliation(s)
- Claire Della Vecchia
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Magali Girodet
- Human and Social Sciences Department/Medical Evaluation and Sarcomas Team, Comprehensive Cancer Care Centre Léon Bérard, Lyon, France.,Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphéline Ginguené
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Camille Carpentier
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Tanguy Leroy
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Arnaud Siméone
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Emilie Vayre
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Xavier Mabire
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Dulce Ferraz
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France.,PHASE (Psychology of Health, Aging and Sport Examination), University of Lausanne Faculty of Social and Political Science, Lausanne, Switzerland
| | - Christine Morin-Messabel
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Marie Préau
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
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Zucchelli A, Sepe C, Tarozzi L, Garelli A, Benedusi F, Pignataro S, Paolillo C, Marengoni A. COVID-19 as an effect modifier of the relationship between age and in-hospital survival in older patients admitted to an Italian Emergency Department. Aging Clin Exp Res 2022; 34:1195-1200. [PMID: 35355242 PMCID: PMC8966861 DOI: 10.1007/s40520-022-02115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/11/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The SARS-CoV-2 pandemic modified how persons got into contact with emergency services, particularly during the first wave. AIM The aim is to describe the characteristics of older persons with and without COVID-19 visiting the Emergency Department of a tertiary hospital and to investigate the impact of age on in-hospital survival in the two groups. METHODS Patients older than 70 years were followed-up till discharge or in-hospital death. Cox regression models stratified by COVID-19 diagnosis were used to investigate survival. RESULTS Out of 896 patients, 36.7% had COVID-19. Those without COVID-19 were older and affected by a higher number of chronic conditions but exhibited lower mortality (10.5 vs 48.1%). After the adjustment, age was associated with mortality only among those with COVID-19. DISCUSSION COVID-19 modified the relationship between older age and in-hospital survival: whether this finding is explained by other biological vulnerabilities or by a selection of treatments based on age should be further investigated.
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Turgeman I, Goshen‐Lago T, Waldhorn I, Karov K, Groisman L, Reiner Benaim A, Almog R, Halberthal M, Ben‐Aharon I. Psychosocial perspectives among cancer patients during the coronavirus disease 2019 (COVID-19) crisis: An observational longitudinal study. Cancer Rep (Hoboken) 2022; 5:e1506. [PMID: 34405968 PMCID: PMC8420321 DOI: 10.1002/cnr2.1506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) crisis and consequent changes in medical practice have engendered feelings of distress in diverse populations, potentially adversely affecting the psychological well-being of cancer patients. AIM The purpose of this observational longitudinal study was to evaluate psychosocial perspectives among patients with cancer on intravenous treatment during the COVID-19 pandemic. METHODS AND RESULTS The study recruited 164 cancer patients undergoing intravenous anti-neoplastic therapy in a tertiary cancer center. Psychosocial indices were assessed at two points in time, corresponding with the beginning of the first wave of COVID-19 pandemic in Israel (March 2020) and the time of easing of restrictions implemented to curtail spread of infection (May 2020). At Time 1 (T1), elevated COVID-19 distress levels (score 1 and 2 on 5-point scale) were observed in 44% of patients, and associated with pre-existing hypertension and lung disease in multivariate analyses but no demographic or cancer related factors. At Time 2 (T2), 10% had elevated anxiety and 24% depression as indicated by Hospital Anxiety and Depression Scale (HADS-A/D). COVID-19 distress at T1 was related to higher levels of HADS-A at T2 (Spearman 0.33 p < .01), but not HADS-D. Patients with breast cancer expressed greater COVID-19 distress compared with other cancer types (p < .01), while both HADS-A and HADS-D were highest for patients with GI cancer. Patient report of loneliness and decreased support from relatives were factors associated with HADS-A (p = .03 and p < .01, respectively), while HADS-D was not similarly related to the factors evaluated. CONCLUSION Patients with cancer undergoing intravenous treatment may be vulnerable to acute adverse psychological ramifications of COVID-19, specifically exhibiting high levels of anxiety. These appear unrelated to patient age or disease stage. Those with underlying comorbidities, breast cancer or reduced social support may be at higher risk.
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Affiliation(s)
- Ilit Turgeman
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | | | - Ithai Waldhorn
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | - Keren Karov
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | - Leora Groisman
- Division of OncologyRambam Health Care CenterHaifaIsrael
| | | | - Ronit Almog
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
- Epidemiology Department and BiobankRambam Health Care CampusHaifaIsrael
| | - Michael Halberthal
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
- General ManagementRambam Health Care CampusHaifaIsrael
| | - Irit Ben‐Aharon
- Division of OncologyRambam Health Care CenterHaifaIsrael
- Technion Integrated Cancer Center (TICC)Faculty of MedicineHaifaIsrael
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Yeo YH, Gao X, Wang J, Li Q, Su X, Geng Y, Huang R, Wu C, Ji F, Sundaram V, Noureddin M, Buti M, Ayoub WS. The impact of COVID-19 on the cascade of care of HCV in the US and China. Ann Hepatol 2022; 27:100685. [PMID: 35192964 PMCID: PMC8857763 DOI: 10.1016/j.aohep.2022.100685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/08/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic imperiled the global health system. We aimed to determine the impact of COVID-19 on the care continuum of HCV-infected patients. MATERIAL AND METHODS Two hundred and fifty-six patients who were prescribed a course of DAA therapy at three tertiary medical centers in the US and China between January 1, 2019 to June 30, 2020 were included. We assessed the proportions of patients who completed DAA therapy and had HCV RNA testing during and after the end of therapy. We also assessed the impact of utilization of telemedicine. RESULTS The proportion of patients undergoing HCV RNA testing during DAA treatment decreased from >81.7% before pandemic to 67.8% during the pandemic (P=0.006), with a more prominent decrease in the US. There were significant decreases in HCV RNA testing >12 (P<0.001) and >20 weeks (P<0.001) post-treatment during COVID-19 era. Compared to pre-COVID period, post-treatment clinic encounters during COVID-19 era decreased significantly in China (Xi'an: 13.6% to 7.4%; Nanjing: 16.7% to 12.5%) but increased in the US (12.5% to 16.7%), mainly due to the use of telemedicine. There was a 4-fold increase in utilization of telemedicine in the US. CONCLUSIONS COVID-19 pandemic carried profound impact on care for HCV patients in both the US and China. HCV cure rate assessment decreased by half during COVID era but the proportion of patients finishing DAA therapy was not significantly affected. Increased utilization of telemedicine led to increased compliance with DAA therapy but did not encourage patients to have their laboratory assessment for HCV cure.
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Affiliation(s)
- Yee Hui Yeo
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Xu Gao
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Qingyu Li
- School of Medicine, University of California, Los Angeles, CA, USA
| | - Xingyang Su
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yu Geng
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Fanpu Ji
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Vinay Sundaram
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mazen Noureddin
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Maria Buti
- Liver Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBEREHD del Instituto Carlos III, Barcelona, Spain
| | - Walid S Ayoub
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Impact of the COVID-19 Pandemic on Oncology Patients’ Mental Health and Treatment Plans. Healthcare (Basel) 2022; 10:healthcare10050825. [PMID: 35627962 PMCID: PMC9141433 DOI: 10.3390/healthcare10050825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022] Open
Abstract
The COVID-19 pandemic has disrupted cancer care to a certain degree. There is objective evidence that COVID-19 outbreaks are causing substantial emotional distress among cancer patients regardless of their disease severity. This study aims to measure the levels of psychological distress, depression, and pandemic anxiety among cancer patients in Saudi Arabia during the outbreak of COVID-19 and their impact on patients’ cancer treatment plans. Methods: This was a cross-sectional study conducted among oncology patients in Saudi Arabia in November of 2020. The levels of stress, depression, and anxiety symptoms during the COVID-19 outbreak were measured using the Questionnaire for Depression and Anxiety (PHQ-4), and patients were classified as depressed/distressed if the total score was 6 and above and classified as not depressed/distressed if they scored less than 6. Results: Among the sampled population, anxiety symptoms and depression were detected in 61.5% and 70.2%, respectively. Statistical analyses revealed that feeling more isolated was significant for anxiety symptoms (p = 0.005), while patients who used institutions as a source of COVID-19 information had significant depression (p = 0.010) compared to patients who accessed information from other sources. In the binary regression model, feeling more isolated than before was 3.208 times more likely to be associated with anxiety symptoms (OR = 3.208; 95% CI = 1.391–7.396; p = 0.006), while those patients who had a support institution as a source of COVID-19 information were 4.2 times more likely to be associated with depression (OR = 4.200; 95% CI = 1.328–13.280; p = 0.015). Conclusion: The COVID-19 pandemic has added to the burden on cancer patients. The increased risk of anxiety symptoms and depression was clearly demonstrated in this study. Feeling isolated had a greater impact on anxiety symptoms, while obtaining COVID-19 information from a patient support institution negatively affected depression.
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Buske C, Dreyling M, Alvarez-Larrán A, Apperley J, Arcaini L, Besson C, Bullinger L, Corradini P, Giovanni Della Porta M, Dimopoulos M, D'Sa S, Eich HT, Foà R, Ghia P, da Silva MG, Gribben J, Hajek R, Harrison C, Heuser M, Kiesewetter B, Kiladjian JJ, Kröger N, Moreau P, Passweg JR, Peyvandi F, Rea D, Ribera JM, Robak T, San-Miguel JF, Santini V, Sanz G, Sonneveld P, von Lilienfeld-Toal M, Wendtner C, Pentheroudakis G, Passamonti F. Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus. ESMO Open 2022; 7:100403. [PMID: 35272130 PMCID: PMC8795783 DOI: 10.1016/j.esmoop.2022.100403] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has created enormous challenges for the clinical management of patients with hematological malignancies (HMs), raising questions about the optimal care of this patient group. METHODS This consensus manuscript aims at discussing clinical evidence and providing expert advice on statements related to the management of HMs in the COVID-19 pandemic. For this purpose, an international consortium was established including a steering committee, which prepared six working packages addressing significant clinical questions from the COVID-19 diagnosis, treatment, and mitigation strategies to specific HMs management in the pandemic. During a virtual consensus meeting, including global experts and lead by the European Society for Medical Oncology and the European Hematology Association, statements were discussed and voted upon. When a consensus could not be reached, the panel revised statements to develop consensual clinical guidance. RESULTS AND CONCLUSION The expert panel agreed on 33 statements, reflecting a consensus, which will guide clinical decision making for patients with hematological neoplasms during the COVID-19 pandemic.
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Affiliation(s)
- C Buske
- Institute of Experimental Cancer Research, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
| | - M Dreyling
- Department of Medicine III at LMU Hospital, Munich, Germany
| | - A Alvarez-Larrán
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - J Apperley
- Centre for Haematology, Imperial College London, Hammersmith Hospital, London, UK
| | - L Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - C Besson
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France; UVSQ, Inserm, CESP, Villejuif, France
| | - L Bullinger
- Department of Hematology, Oncology, and Tumorimmunology, Campus Virchow Klinikum, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - P Corradini
- Hematology Division, University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Giovanni Della Porta
- Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S D'Sa
- UCLH Centre for Waldenström and Neurohaematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - H T Eich
- Department of Radiation Oncology, University of Muenster, Münster, Germany
| | - R Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - P Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia and Laboratory of B Cell Neoplasia, Division of Molecular Oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - M G da Silva
- Department Of Hematology, Portuguese Institute of Oncology, Lisbon, Portugal
| | - J Gribben
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - R Hajek
- Department of Hematooncology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - C Harrison
- Clinical Director - Haematology, Haemostasis, Palliative Care, Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hanover, Germany
| | - B Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - J J Kiladjian
- Université de Paris, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, Paris, France
| | - N Kröger
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - P Moreau
- Hematology Department, University Hospital Hotel-Dieu, Nantes, France
| | - J R Passweg
- Hematology Division, Basel University Hospital, Basel, Switzerland
| | - F Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - D Rea
- University Medical Department of Hematology and Immunology, France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Hôpital Saint-Louis, Paris, France
| | - J-M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - T Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - J F San-Miguel
- Clínica Universidad de Navarra (CUN), Centro de Investigación Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC, Pamplona, Spain
| | - V Santini
- MDS Unit, Hematology, DMSC, AOUC, University of Florence, Florence, Italy
| | - G Sanz
- Hematology Department, Hospital Univesitario y Politecnico La Fe, Valencia; CIBERONC, IS Carlos III, Madrid, Spain
| | - P Sonneveld
- Erasmus MC Cancer Institute, Department of Haematology, Rotterdam, The Netherlands
| | - M von Lilienfeld-Toal
- Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - C Wendtner
- Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany
| | - G Pentheroudakis
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - F Passamonti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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48
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Marino P, Touzani R, Pakradouni J, Ben Soussan P, Gravis G. The Psychological Distress of Cancer Patients following the COVID-19 Pandemic First Lockdown: Results from a Large French Survey. Cancers (Basel) 2022; 14:cancers14071794. [PMID: 35406566 PMCID: PMC8997456 DOI: 10.3390/cancers14071794] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 01/09/2023] Open
Abstract
Cancer patients commonly experience psychological distress that may increase with the current COVID-19 pandemic. This prospective study aimed to measure post-traumatic stress disorder (PTSD) and anxiety in cancer patients following France’s first COVID-19-related lockdown, together with associated factors. Cancer patients receiving outpatient treatment or post-treatment follow-up completed a questionnaire which measured, among other things, PTSD (IES-R), anxiety (State-Trait Anxiety Inventory), and fear of cancer recurrence (FCR). Of the 1097 patients included in the study, 14.7% and 30.5% suffered from PTSD and anxiety, respectively. Patients afraid to come to hospital due to the risk of COVID-19 transmission (OR = 3.49, p < 0.001), those with a negative lockdown experience (OR = 0.98, p < 0.001), women (OR = 1.97; p = 0.009), and patients living alone (OR = 1.63, p = 0.045) were all more likely to have PTSD. Older patients (OR = 1.65, p = 0.020), women (OR = 1.62, p = 0.018), those with a higher FCR score (OR = 5.02, p < 0.001), patients unsatisfied with their cancer management (OR = 2.36, p < 0.001), and those afraid to come to hospital due to COVID-19 (OR = 2.43, p < 0.001) all had a higher risk of anxiety. These results provide a greater understanding of the psychological consequences of the COVID-19 pandemic in cancer patients and highlight the need to better integrate psychosocial support in pandemic response measures in order to guide health systems.
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Affiliation(s)
- Patricia Marino
- Institut Paoli-Calmettes, SESSTIM, INSERM, IRD, Aix Marseille University, 13009 Marseille, France;
- Correspondence:
| | - Rajae Touzani
- Institut Paoli-Calmettes, SESSTIM, INSERM, IRD, Aix Marseille University, 13009 Marseille, France;
| | - Jihane Pakradouni
- Department of Clinical Research and Innovation, Institut Paoli-Calmettes, 13009 Marseille, France;
| | - Patrick Ben Soussan
- Department of Clinical Psychology, Institut Paoli-Calmettes, 13009 Marseille, France;
| | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille University, CRCM, 13009 Marseille, France;
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49
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Morganti AG, Macchia G, Cellini F, Deodato F, Zamagni A, Siepe G, Buwenge M. A "SHort course Accelerated RadiatiON therapy" (SHARON) During and Beyond the COVID-19 Pandemic. Front Oncol 2022; 12:823445. [PMID: 35280809 PMCID: PMC8904873 DOI: 10.3389/fonc.2022.823445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alessio G Morganti
- Radiation Oncology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Gabriella Macchia
- Gemelli Molise Hospital, Radiotherapy Unit, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Francesco Cellini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Deodato
- Gemelli Molise Hospital, Radiotherapy Unit, Università Cattolica del Sacro Cuore, Campobasso, Italy.,Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Alice Zamagni
- Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Giambattista Siepe
- Radiation Oncology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum - Bologna University, Bologna, Italy
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50
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Safety and Feasibility of Lung Cancer Surgery under the COVID-19 Circumstance. Cancers (Basel) 2022; 14:cancers14051334. [PMID: 35267642 PMCID: PMC8909353 DOI: 10.3390/cancers14051334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary The global coronavirus disease 2019 (COVID-19) pandemic has drastically changed the current practice of medicine worldwide. As more clinical data is collected and processed, we are beginning to have an understanding of which patients are more at risk for severe complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Preliminary data has shown that patients with lung cancer are disproportionally affected by the current COVID-19 pandemic. Furthermore, studies have shown that lung cancer patients are also significantly more likely to be admitted to the ICU and need mechanical ventilation. A specific subset of patients that are even more at risk for severe COVID-19 are those that require lung cancer surgery. To minimize the risk of SARS-CoV-2 infections in patients undergoing surgery, new treatment guidelines and preventive measures are necessary. In this review, we summarize the latest evidence regarding recommendations for patients undergoing lung cancer surgery in the COVID-19 era. Abstract The current coronavirus disease 2019 (COVID-19) pandemic has forced healthcare providers worldwide to adapt their practices. Our understanding of the effects of COVID-19 has increased exponentially since the beginning of the pandemic. Data from large-scale, international registries has provided more insight regarding risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and has allowed us to delineate specific subgroups of patients that have higher risks for severe complications. One particular subset of patients that have significantly higher risks of SARS-CoV-2 infection with higher morbidity and mortality rates are those that require surgical treatment for lung cancer. Earlier studies have shown that COVID-19 infections in patients that underwent lung cancer surgery is associated with higher rates of respiratory failure and mortality. However, deferral of cancer treatments is associated with increased mortality as well. This creates difficult situations in which healthcare providers are forced to weigh the benefits of surgical treatment against the possibility of SARS-CoV-2 infections. A number of oncological and surgical organizations have proposed treatment guidelines and recommendations for patients planned for lung cancer surgery. In this review, we summarize the latest data and recommendations for patients undergoing lung cancer surgery in the COVID-19 circumstance.
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