|
1
|
Eljilany I, Garcia JR, Jamal B, Tarhini AA. Monoclonal antibodies as adjuvant therapies for resected melanoma. Expert Opin Biol Ther 2025:1-14. [PMID: 40125987 DOI: 10.1080/14712598.2025.2484305] [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: 11/25/2024] [Revised: 03/04/2025] [Accepted: 03/21/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Systemic adjuvant therapy is indicated in patients with high-risk, resected melanoma management to reduce recurrence risk and potentially improve survival rates. Monoclonal antibodies (mAbs) target immune checkpoints and have made significant advances as adjuvant therapy. AREAS COVERED This review discusses the main clinical trials that tested adjuvant mAbs in resected high-risk melanoma, including anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1); in addition to newer immunotherapies being tested in the adjuvant setting, including anti-lymphocyte activation gene 3 (LAG-3). We also briefly discuss targeted therapies as an alternative choice. Moreover, we highlight the pros and cons of using mAbs in the adjuvant setting, the reported adverse events (AEs), and the quality of life impact. Finally, we report data related to biomarker studies tested in the context of these clinical trials. EXPERT OPINION Immune checkpoint inhibitors (ICIs) have been shown to significantly improve relapse-free survival (RFS) as adjuvant therapy for high-risk melanoma. In contrast, the long-term impact on overall survival (OS) was demonstrated in two studies that tested ipilimumab versus placebo (EORTC18071) and interferon-α (ECOG-ACRIN E1609). Furthermore, emerging data with neoadjuvant therapy followed by surgery and adjuvant therapy utilizing ICIs has demonstrated improved outcomes in the management of locoregionally advanced disease.
Collapse
Affiliation(s)
- Islam Eljilany
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Julia R Garcia
- Department of Medical Oncology, Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | - Basmala Jamal
- Department of Health Sciences, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ahmad A Tarhini
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| |
Collapse
|
|
2
|
Silverstein J, Goyal N, Tsai KK. For the Long Haul: Management of Long-Term Survivors after Melanoma Systemic Therapy. Curr Oncol Rep 2024; 26:804-817. [PMID: 38780676 DOI: 10.1007/s11912-024-01541-6] [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] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE OF REVIEW This review summarizes the latest advancements in survivorship care for patients with advanced melanoma who received systemic therapy and emphasizes the areas where more research is needed. RECENT FINDINGS Over the last decade there have been remarkable advances in the treatment of advanced and metastatic melanoma. Due to these novel treatments, including several immune checkpoint inhibitors and tyrosine kinase inhibitors, there are and will continue to be increasing numbers of long-term melanoma survivors who have been treated with systemic therapy. These patients will navigate new challenges are they are essentially among the first long term survivors after these novel therapies. Survivorship care focuses on improving the health-related quality of life of patients including the physical, emotional, social and functional effects of cancer that begin at diagnosis and continue through the end of life. Survivorship also includes screening for cancer recurrence and second cancers. As the number of melanoma survivors who received systemic therapy continues to grow, the survivorship care plan will become increasingly important for optimal care of patients even after their cancer treatments. Understanding the many domains of survivorship care for this group of patients is imperative for their care now and to identify unmet needs for future research.
Collapse
Affiliation(s)
- Jordyn Silverstein
- Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles (UCLA), 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
| | - Neha Goyal
- Department of Psycho-Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Katy K Tsai
- Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco (UCSF), San Francisco, CA, USA
| |
Collapse
|
|
3
|
Kungwengwe G, Gowthorpe C, Ali SR, Warren H, Drury DJ, Ang KL, Gibson JAG, Dobbs TD, Whitaker IS. Prevalence and odds of anxiety and depression in cutaneous malignant melanoma: a proportional meta-analysis and regression. Br J Dermatol 2024; 191:24-35. [PMID: 38197404 DOI: 10.1093/bjd/ljae011] [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: 07/09/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND The psychological burden of cutaneous malignant melanoma (CM) is all-encompassing, affecting treatment adherence, recurrence and mortality. However, the prevalence and risk factors of anxiety and depression in CM remain unclear. OBJECTIVES To establish a benchmark pooled prevalence of anxiety and depression in CM, to provide magnitudes of association for clinical, therapeutic and demographic correlates, and to elucidate temporal trends in anxiety and depression from the time of diagnosis. METHODS This review followed the MOOSE guidelines. MEDLINE, Embase, PsychINFO, Web of Science and the Cochrane Library were queried from database inception to 24 August 2023. Study selection, data extraction and quality assessment were performed by two independent authors, utilizing both the Joanna Briggs Institute (JBI) and National Institutes of Health risk-of-bias tools for the latter. The GRADE approach was used to rate the certainty of evidence. Prevalence rates, 95% confidence intervals (CIs) and prediction intervals (PIs) were derived using a random-effects model and estimating between- and within-study variance. RESULTS Nine longitudinal and 29 cross-sectional studies were included (7995 patients). Based on the JBI and NIH tools, respectively, quality assessment found 20 and 17 to be at low risk of bias, 12 and 15 to be at moderate risk and 6 and 5 to be at high risk of bias. The prevalence of anxiety [30.6% (95% CI 24.6-37.0; PI 18-47%)] and depression [18.4% (95% CI 13.4-23.9; PI 10-33%)] peaked during treatment, declining to pretreatment levels after 1 year [anxiety: 48% vs. 20% (P = 0.005); depression: 28% vs. 13% (P = 0.03)]. Female sex [odds ratio (OR) 1.8, 95% CI 1.4-2.3; P < 0.001], age < 60 years (OR 1.5, 95% CI 1.2-2.0; P = 0.002) and low educational level (OR 1.5, 95% CI 1.2-2.0; P < 0.001) were likely to result in a large increase in the odds of anxiety. Depression was 12.3% higher in those with stage IV vs. those with stage I CM (P = 0.05). Relative to immune checkpoint inhibition, the rates of depression were 22% (P = 0.002) and 34% (P < 0.001) higher among patients with advanced-stage CM receiving interferon-α and chemotherapy, respectively. A significant reduction in self-reported depression scores was demonstrated over time (P = 0.003). CONCLUSIONS Notably, anxiety and depression in CM affect women, those younger than 60 years of age and the less educated, with up to 80% higher odds of anxiety in these groups. Anxiety and depression surge during chemotherapy and interferon treatment, especially in advanced CM. Our findings facilitate risk stratification and underscore the need for multidisciplinary vigilance.
Collapse
Affiliation(s)
- Garikai Kungwengwe
- Chelsea and Westminster Hospital, Imperial College Healthcare Trust, London, UK
| | | | - Stephen R Ali
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | | | - Damien J Drury
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | | | - John A G Gibson
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - Thomas D Dobbs
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - Iain S Whitaker
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| |
Collapse
|
|
4
|
Forbes C, Tanner S, Engstrom T, Lee WR, Patel D, Walker R, Bradford N, Pole JD. Patient Reported Fatigue Among Adolescent and Young Adult Cancer Patients Compared to Non-Cancer Patients: A Systematic Review and Meta-Analysis. J Adolesc Young Adult Oncol 2024; 13:242-250. [PMID: 37902970 DOI: 10.1089/jayao.2023.0094] [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] [Indexed: 11/01/2023] Open
Abstract
Adolescent and young adult (AYA) cancer patients and survivors are a growing population due to more frequent diagnoses and improved survival. Fatigue is a common symptom experienced by cancer patients and it is often missed by health care professionals. Patient reported outcome measures (PROMs) can assist in evaluating patient reported fatigue. This systematic review aims to determine if AYA cancer patients report more fatigue than AYAs who have not been diagnosed with cancer. We used a subset of articles from a larger review that searched PubMed, EMBASE, CINAHL, and PsycINFO to determine which PROMs and domains are currently being used to evaluate AYA cancer. This study identified 175 articles related to PROMs in the AYA cancer population. Articles with PROMs reporting on fatigue/vitality were used in this review. From the original 175 articles, we identified 8 fatigue/vitality articles for this review. All eight articles found an increase in fatigue/decrease in vitality in the AYA cancer population compared to healthy controls. A meta-analysis was performed on four articles that used the same PROM tool (EORTC QLQ-C30). This found a statistically significant and clinically meaningful increase in mean fatigue of 12.5 95% confidence interval: 3.3-21.8 points (scale 0-100, higher number indicates more fatigue) in the AYA cancer group compared to healthy noncancer controls. Fatigue in the AYA cancer population is a significant issue, it is often undetected and underreported, and early interventions are needed to prevent the negative subsequent sequelae.
Collapse
Affiliation(s)
- Cheryl Forbes
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Sarah Tanner
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Teyl Engstrom
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Wen Ray Lee
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Dhaval Patel
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Rick Walker
- School of Medicine, The University of Queensland, Herston, Australia
- Oncology Service, Queensland Children's Hospital, Brisbane, Australia
- Cancer Care, Princess Alexandra Hospital, Brisbane, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Jason D Pole
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| |
Collapse
|
|
5
|
Magnani C, Smith AB, Rey D, Sarradon-Eck A, Préau M, Bendiane MK, Bouhnik AD, Mancini J. Fear of cancer recurrence in young women 5 years after diagnosis with a good-prognosis cancer: the VICAN-5 national survey. J Cancer Surviv 2023; 17:1359-1370. [PMID: 35318569 DOI: 10.1007/s11764-022-01193-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is frequent in survivors, but less is known about FCR in long-term survivors with very low risk of relapse. Our aim was to estimate the prevalence and clinical and socio-behavioural factors associated with FCR in young women 5 years after diagnosis of a good-prognosis cancer. METHODS Using data from the VICAN-5 survey, conducted in 2015-2016 amongst a national representative French sample of cancer survivors, we included women with non-metastatic melanoma, breast, or thyroid cancer, aged 55 years or under at diagnosis, who experienced no disease progression in the 5 years post-diagnosis. Multinomial logistic regression was used to identify factors associated with FCR, characterised using a three-level indicator: no, mild, and moderate/severe FCR. RESULTS Amongst the 1153 women included, mean age was 44 years at diagnosis, and 81.8% had breast cancer, 12.5% thyroid cancer, and 5.8% melanoma. Five years after diagnosis, 35.4% reported no FCR, 46.0% mild FCR, and 18.6% moderate/severe FCR. Women with thyroid cancer were less likely to suffer from mild or moderate/severe FCR, while cancer-related treatment sequelae, fatigue, and anxiety were more likely. Limited health literacy was associated with mild FCR. Women who reported only occasionally consulting a general practitioner (GP) for the management of their cancer had a higher probability of FCR. CONCLUSION Moderate/severe FCR affected nearly 20% of young female long-term survivors diagnosed with a good-prognosis cancer, particularly those reporting cancer-related sequelae, suffering from fatigue or anxiety, with breast cancer or melanoma (versus thyroid cancer), and consulting a GP only occasionally for cancer management. IMPLICATIONS FOR CANCER SURVIVORS Given the recognised impact of FCR on quality of life, it is essential to detect it as early as possible, and to implement targeted interventions in routine care.
Collapse
Affiliation(s)
| | - Allan Ben Smith
- Ingham Institute for Applied Medical Research, New South Wales, Sydney, Australia
- South Western Sydney Clinical School, University of New South Wales, New South Wales, Liverpool, Australia
| | - Dominique Rey
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Aline Sarradon-Eck
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- Institut Paoli-Calmettes, SESSTIM, Marseille, France
| | - Marie Préau
- Unité UMR 1296 «Radiations: Défense, Santé, Environnement», Lyon, France
- Institut de Psychologie, Université Lumière Lyon 2, Bron, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France.
| | - Julien Mancini
- Aix Marseille Univ, APHM, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
| |
Collapse
|
|
6
|
Young JN, Griffith‐Bauer K, Hill E, Latour E, Samatham R, Leachman S. The benefit of early-stage diagnosis: A registry-based survey evaluating the quality of life in patients with melanoma. SKIN HEALTH AND DISEASE 2023; 3:e237. [PMID: 37538330 PMCID: PMC10395626 DOI: 10.1002/ski2.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 08/05/2023]
Abstract
Background The morbidity associated with advanced stage melanoma is an important consideration in the dialog surrounding early detection and overdiagnosis. Few studies have stratified melanoma patient quality of life (QoL) by stage at diagnosis. Objective We sought to investigate if melanoma stage is independently associated with changes in QoL within a large, community-based melanoma registry. Secondarily, we investigated whether demographic factors such as age, geographic location or level of education are associated with changes in QoL in the same population. Methods 1108 melanoma patients were surveyed over a three-month period using the QoL in Adult Cancer Survivors Survey, consisting of 47 items on a 7-point frequency scale. Data were analysed using both descriptive statistical models and adjusted multivariate logistic regression. Results There were 677 respondents generating a 61% response rate. Overall, higher stage at diagnosis correlated with the largest decreases in QoL as it pertained to both general (p = 0.001) and Cancer-Specific stressors (p < 0.001). Education level (p = 0.020), age (p < 0.001), rural area code designation (p = 0.020) and family history of melanoma (p = 0.017) were also independently associated with changes in QoL. Conclusion Earlier stage at melanoma diagnosis is associated with better QoL and thus represents a crucial intervention in patient care. Given our findings and the growing body of evidence surrounding morbidity in late-stage melanoma, it is essential that QoL be included in assessing the benefits of early detection.
Collapse
Affiliation(s)
- Jade N. Young
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Kelly Griffith‐Bauer
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
- The PolyclinicSeattleWashingtonUSA
| | - Emma Hill
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Emile Latour
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
- Biostatistics Shared ResourceKnight Cancer InstituteOregon Health and Science UniversityPortlandOregonUSA
| | - Ravikant Samatham
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| | - Sancy Leachman
- Department of DermatologyOregon Health and Science UniversityPortlandOregonUSA
| |
Collapse
|
|
7
|
Stenzel AE, Miller J, Holtan SG, Brown K, Ahmed RL, Lazovich D, Vogel RI. Cross-sectional study of physical activity among long-term melanoma survivors and population controls. Arch Dermatol Res 2023; 315:1011-1016. [PMID: 35201419 PMCID: PMC9399312 DOI: 10.1007/s00403-022-02334-2] [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: 07/06/2021] [Revised: 01/24/2022] [Accepted: 02/10/2022] [Indexed: 11/02/2022]
Abstract
Physical activity has been associated with improved outcomes among cancer survivors of various malignancies; however, this topic is understudied among melanoma survivors. Our objective was to determine whether long-term melanoma survivors are less likely to meet American Cancer Society physical activity guidelines than non-melanoma population controls. We conducted a cross-sectional survey in 2015 to follow up participants from a case-control study of melanoma and population controls in Minnesota. The primary outcome was meeting American Cancer Society recommendations for healthy physical activity levels. Physical activity, sun protection practices and time spent outside were compared between survivors and controls using generalized linear regression models. Melanoma survivors (N = 724) and controls (N = 639) were similar with the exceptions of daily hours spent outside, sun protection scores, skin tone, and smoking status. Half (50.8%) of melanoma survivors reported meeting the physical activity guidelines, compared to 39.7% of controls (p < 0.0001), with an 11% (95% CI 0.05-0.17) difference after adjusting for potential confounders. While long-term melanoma survivors were more likely to meet American Cancer Society physical activity guidelines than population controls, nearly 50% did not meet recommendations. This finding is concerning given the known improvements in quality of life and survival among physically active cancer survivors. Opportunities remain to promote physical activity among melanoma survivors. Health communications that promote outdoor exercise, in particular, should include advice about sun protection.
Collapse
Affiliation(s)
- Ashley E Stenzel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jonathan Miller
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Hennepin Health Research Institute, Minneapolis, MN, USA
| | - Shernan G Holtan
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Katherine Brown
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - Rehana L Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA.
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
| |
Collapse
|
|
8
|
Bartula I, Tran AD, Nowak AK, Ahmed T, Morton RL, Burmeister BH, Dolven-Jacobsen K, Nobes J, Thompson JF, Fogarty GB, Lo SN, Hong AM. Longitudinal Trajectory of Quality of Life for Patients with Melanoma Brain Metastases: A Secondary Analysis from a Whole Brain Radiotherapy Randomized Clinical Trial. Clin Transl Radiat Oncol 2023. [DOI: 10.1016/j.ctro.2023.100597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
|
|
9
|
Karakok H, Bostanci S, Akay BN, Calıskan D, Ateş C, Köse K. Validation of the Turkish Version of the Skin Cancer Quality of Life Impact Tool (SCQOLIT): A Health-Related Quality of Life Questionnaire for Non-metastatic Melanoma and Non-melanoma Skin Cancer. Dermatol Pract Concept 2023; 13:dpc.1301a1. [PMID: 36892383 PMCID: PMC9946060 DOI: 10.5826/dpc.1301a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Skin cancer is the third most common type of cancer worldwide that has increased in incidence. Quality of life (QoL) instruments have been developed to measure the efficacy of treatments of cancers.
Objectives: The only validated tool that can be used in both nonmetastatic skin cancer types is the SCQOLIT. This study aimed to validate the Turkish version of the Skin Cancer Quality of Life Impact Tool (SCQOLIT).
Methods: A total of 141 patients diagnosed and treated for skin cancer within the previous 3 months were included. The tool was translated into Turkish in accordance with International Translation Guidelines. The Dermatology Quality of Life Index that was used for external validation. Patient demographics were recorded.
Results: Question 3 had a factor load of 0.372, indicating the inadequacy of this question in predicting QoL, a point that the original study did not mention. The SCQOLIT had external validity, convergent validity and internal consistency (Cronbach alpha=0.863), and test-repeat-test correlation coefficient was 0.824 (95% confidence interval; 0.644 – 0.918). Patients diagnosed with melanoma had poorer QoL scores. High-risk tumor characteristics in nonmelanoma skin cancer and stage of melanoma had no impact on QoL (p=0.235 for basal cell carcinoma, p=1.00 for squamous cell carcinoma, p=0.635 for melanoma).
Conclusions: The Turkish version of the SCQOLIT is validated. Age was shown to have a statistically significant negative correlation with QoL, while Fitzpatrick skin type, gender, risk classification, stage, history of skin cancer, family history of skin cancer and treatment modality had no effect on QoL.
Collapse
Affiliation(s)
- Hilayda Karakok
- Sifa Okulu, Private Practice Office of Dermatology and Venereology, Ataturk Bulvarı, Tasbası Mahallesi, Altınordu - Ordu, Turkey
| | - Seher Bostanci
- Department of Dermatology and Venereology, Ankara University School of Medicine, Turkey
| | - Bengu Nisa Akay
- Department of Dermatology and Venereology, Ankara University School of Medicine, Turkey
| | - Deniz Calıskan
- Department of Public Health, Ankara University School of Medicine, Turkey
| | - Can Ateş
- Department of Biostatistics, Van Yüzüncü Yıl University, School of Medicine
| | - Kenan Köse
- Department of Biostatistics, Ankara University School of Medicine, Turkey
| |
Collapse
|
|
10
|
Tumor Burden and Health-Related Quality of Life in Patients with Melanoma In-Transit Metastases. Cancers (Basel) 2022; 15:cancers15010161. [PMID: 36612157 PMCID: PMC9817978 DOI: 10.3390/cancers15010161] [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: 10/30/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Few studies have investigated the health-related quality of life (HRQOL) in patients with melanoma in-transit metastases (ITM). The aim was to investigate the association between tumor burden and HRQOL, including disparities pertaining to sex and age, in treatment-naïve patients with ITM. METHODS Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire was used to assess HRQOL Pairwise comparisons using t-tests between clinical cutoffs are presented and multiple linear regression analysis showing the unique associations of gender, age, number of tumors, tumor size, presence of lymph node metastases, and tumor localization. RESULTS A total of 95 patients, 47% females and 53% males (median age 72 years) were included between 2012 and 2021. Women scored significantly lower on emotional well-being (p = 0.038) and lower on FACT-M (p = 0.058). Patients who had ≥10 tumors scored significantly lower on FACT-M (p = 0.015), emotional- and functional well-being (p = 0.04, p = 0.004, respectively), melanoma scale (p = 0.005), and FACT-G (p = 0.027). There was no significant difference in HRQOL depending on age, size of tumors, localization, or presence of lymph node metastases. CONCLUSION For patients with melanoma ITMs, the female sex and higher tumor burden (i.e., number of tumors) were significantly correlated with lower HRQOL. However, these findings do not fully explain HRQOL for this patient population, and future research should consider the possibility that there are specific questions for patients with ITM where current instruments might fail to measure their discomfort to the full extent.
Collapse
|
|
11
|
Baseline characteristics of adults with neurofibromatosis enrolled on a psychosocial randomized controlled trial. J Neurooncol 2022; 159:637-646. [PMID: 35925531 DOI: 10.1007/s11060-022-04104-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/25/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Neurofibromatosis (NF) is an incurable genetic neurological condition. Psychosocial interventions that promote resiliency are a promising approach to address the high emotional distress and low quality of life (QoL) associated with NF. However, no studies have examined the psychosocial needs of treatment-seeking adults with NF. Our goal was to explore, using data from the largest efficacy trial of a psychosocial intervention for NF, differences in QoL, emotional distress, resiliency, and pain-related outcomes compared to other chronic medical populations and within subtypes (NF1, NF2, schwannomatosis; SCHW). METHODS Enrolled participants (N = 228) were geographically diverse adults with NF and elevated stress. We performed secondary analysis on baseline measures of QoL, emotional distress, resiliency, and pain-related outcomes. We reported descriptive statistics and normative comparisons to understand the psychosocial characteristics of the overall sample and performed between-group analyses to explore differences within NF type. RESULTS Our sample endorsed worse QoL, emotional distress, resilience, and pain-related outcomes than similar chronic illness populations. Within NF types, participants with NF1 reported lower QoL and resilience compared to those with NF2. Participants with SCHW reported higher pain intensity than those with NF1. Participants with SCHW reported higher pain interference and lower physical QoL compared to those with NF1 and NF2. CONCLUSIONS Our findings support the urgent need for psychosocial interventions targeting deficits in QoL, emotional distress, resilience, and pain-related outcomes in adults with NF. We recommend efforts to enhance sample diversity, prepare clinicians to provide high-levels of support, and attune skills training to each NF type. TRIAL REGISTRATION ClinicalTrials.gov NCT03406208; https://clinicaltrials.gov/ct2/show/NCT03406208 (Archived by WebCite at http://www.webcitation.org/72ZoTDQ6h ).
Collapse
|
|
12
|
Kamminga NCW, van der Veldt AAM, Joosen MCW, de Joode K, Joosse A, Grünhagen DJ, Nijsten TEC, Wakkee M, Lugtenberg M. Experiences of resuming life after immunotherapy and associated survivorship care needs: a qualitative study among patients with metastatic melanoma. Br J Dermatol 2022; 187:381-391. [PMID: 35596713 PMCID: PMC9545549 DOI: 10.1111/bjd.21670] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/30/2022]
Abstract
Background Immune checkpoint inhibitors (ICIs) have significantly improved the overall survival of patients with metastatic melanoma. It is unclear how the growing group of metastatic melanoma survivors resume their lives after treatment, and which needs they have regarding survivorship care (SSC). Objectives To gain an in‐depth understanding of metastatic melanoma survivors’ experiences of resuming life after ICIs and their associated SSC needs. Methods A qualitative study was conducted among 20 patients with metastatic melanoma in whom ICIs had been discontinued after ongoing tumour response. One focus group (n = 9) was held, which was complemented by 11 individual interviews. Purposive sampling was used to select a variable sample in terms of sex, age, time since discontinuation of ICIs, and perceived impact of the disease. A topic guide was used to structure the (group) interviews, which were transcribed verbatim and analysed in a thematic content analysis, using several phases of coding. Results In resuming life after ICIs, the prognosis switch often caused mixed feelings among patients, mainly because of the uncertainty about the future. Demands and expectations from self and others, persistent complaints and new problems in different life domains often make it challenging to proceed with life as it was prior to metastatic cancer. Patients indicated they needed to find a new balance, which included learning to cope with uncertainty and a changed perspective on life and close relationships. In terms of SSC needs, patients particularly stressed the need for more tailored patient information, available at one location. In addition, they emphasized the need to know who to turn to in case of questions and indicated the need for psychosocial support, also for their close relatives. Conclusions Metastatic melanoma survivors face various challenges in resuming life after ICIs and are left with several unmet SSC needs. Efforts should be focused on offering psychosocial supportive care in addition to medical care, from diagnosis onwards, taking into account the patient’s close relatives. A single point of contact and personalized survivorship care plan (SCP) could be of added value in guiding them through the patient journey, which is, given its multidisciplinary nature, particularly important in melanoma care. What is already known about this topic?
Since the introduction of immune checkpoint inhibitors (ICIs) the overall survival of patients with metastatic melanoma has improved significantly, leading to a growing group of melanoma survivors. Melanoma survivors may face various problems and challenges in resuming life after treatment, which may be associated with unmet survivorship care (SSC) needs. An in‐depth understanding of their experiences with resuming life and the associated SSC needs is currently lacking. What does this study add?
Metastatic melanoma survivors experience various challenges after immunotherapy, from the uncertain prognosis switch to the struggle of finding a new balance in life. Besides negative aspects, such as complaints in different life domains, the patient journey is often accompanied by positive outcomes, for example a changed perspective on life. They stress the need for tailored patient information and broader supportive care, also for their close relatives. What are the clinical implications of this work?
In addition to medical care, efforts should be focused on offering psychosocial supportive care, including return‐to‐work issues, from diagnosis onwards, ideally taking into account the patient’s close relatives. To guide them through the patient journey, a single point of contact and a personalized survivorship care plan (SCP) could be of added value. The latter is particularly important in melanoma care, given its multidisciplinary nature. With this qualitative study we provided an in‐depth understanding of metastatic melanoma survivors' experiences of resuming life after ICIs and their associated SSC needs. They face various challenges in resuming life and efforts should be focused on offering psychosocial supportive care, in addition to medical care, from diagnosis onwards, taking into account the patient's close relatives. A single point of contact and personalized survivorship care plan (SCP) could be of added value in guiding them through the patiënt journey which is, given its multidisciplinary nature, particularly important in melanoma care. Linked Comment:E.N. Clarke. Br J Dermatol 2022; 187:286–287.
Collapse
Affiliation(s)
- Nadia C W Kamminga
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Astrid A M van der Veldt
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Margot C W Joosen
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Karlijn de Joode
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Arjen Joosse
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Dirk J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Marjolein Lugtenberg
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.,Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
|
13
|
Bach A, Knauer K, Graf J, Schäffeler N, Stengel A. Psychiatric comorbidities in cancer survivors across tumor subtypes: A systematic review. World J Psychiatry 2022; 12:623-635. [PMID: 35582337 PMCID: PMC9048448 DOI: 10.5498/wjp.v12.i4.623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/20/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psychiatric disorders are common but underdiagnosed in cancer survivors. Research suggests that tumor type has an effect on the prevalence of clinically relevant depression, anxiety, comorbid anxiety-depression and posttraumatic stress disorder (PTSD).
AIM To identify studies that examined the prevalence of clinically relevant levels of depression, anxiety, comorbid anxiety-depression and PTSD for patients with one or more tumor sites and compare those prevalences between cancer subtypes.
METHODS Four databases (PubMed, PsycInfo, PubPsych and the Cochrane Database) were searched and resulted in a total of 2387 articles to be screened. To be included, a study must have investigated cancer-free and posttreatment survivors using tools to assess clinically relevant levels of the listed psychiatric comorbidities. All articles were screened by two authors with a third author reviewing debated articles.
RESULTS Twenty-six studies on ten different tumor types fulfilled all inclusion criteria and were included in the review. The studies showed heterogeneity regarding the study characteristics, number of participants, time since diagnosis, and assessment tools. Generally, all four comorbidities show higher prevalences in cancer survivors than the general population. Brain tumor survivors were reported to have a relatively high prevalence of both depression and anxiety. Studies with melanoma survivors reported high prevalences of all four psychiatric comorbidities. Regarding comorbidities, a wide range in prevalence existed across the tumor types. Within one cancer site, the prevalence also varied considerably among the studies.
CONCLUSION Psychiatric comorbidities are more frequent in cancer survivors than in the general population, as reflected by the prevalence of depression, anxiety, comorbid anxiety-depression and PTSD across all tumor subtypes. Developing generalized screening tools that examine psychological distress in cancer survivors up to at least ten years after diagnosis could help to understand and address the psychological burden of cancer survivors.
Collapse
Affiliation(s)
- Anne Bach
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Klara Knauer
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Johanna Graf
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Norbert Schäffeler
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Andreas Stengel
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
- Germany & Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin 10117, Germany
| |
Collapse
|
|
14
|
Tufvesson Stiller H, Mikiver R, Uppugunduri S, Schmitt-Egenolf M. Perception of information to Swedish melanoma patients in routine clinical practice - a cross-sectional survey. BMC Cancer 2022; 22:159. [PMID: 35139808 PMCID: PMC8829993 DOI: 10.1186/s12885-022-09208-w] [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: 06/24/2021] [Accepted: 01/03/2022] [Indexed: 11/12/2022] Open
Abstract
Background Comprehensible, relevant information empowers patients, allowing them to take an active part in their care. We aim to investigate how Swedish melanoma patients perceive information provided in routine clinical practice and explore the correlation between satisfaction with information, symptoms and functioning scales, and quality of life. Methods A cross-sectional study where EORTC QLQ-C30, EORTC QLQ-INFO25 and EQ-5D-3L questionnaires were sent to 1213 patients by post and 792 responded (65%). Results Only 0.5% reported that they wished to have received less information. The amount of information received and the satisfaction with that information was age-dependent, where older patients reported receiving less information than younger patients. Middle-aged patients were more satisfied with the information compared to both younger and older patients. The perception of having received sufficient information correlated negatively with anxiety. Higher satisfaction with the information also correlated positively with scores for functioning scales and negatively with degree of symptoms. No difference was perceived in information levels between disease stage apart from the scale “information about other services”, where patients with more severe disease reported receiving more information. Men and women reported equal satisfaction concerning the information received. Conclusions Patients lack sufficient information and age affects the perception of it. It is of utmost importance to tailor the information to suit the individual needs of a given patient, as satisfaction with the information received correlates with the patient’s well-being.
Collapse
Affiliation(s)
- Helena Tufvesson Stiller
- Department of Public Health and Clinical Medicine, Dermatology, Umeå University, Umeå, Sweden. .,Regional Cancer Centre South East, Linköping, Sweden.
| | | | - Srinivas Uppugunduri
- Regional Cancer Centre South East, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marcus Schmitt-Egenolf
- Department of Public Health and Clinical Medicine, Dermatology, Umeå University, Umeå, Sweden
| |
Collapse
|
|
15
|
Pride RLD, Miller CJ, Murad MH, Erwin PJ, Brewer JD. Local Recurrence of Melanoma Is Higher After Wide Local Excision Versus Mohs Micrographic Surgery or Staged Excision: A Systematic Review and Meta-analysis. Dermatol Surg 2022; 48:164-170. [PMID: 34889212 DOI: 10.1097/dss.0000000000003309] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Complete removal of melanoma is a primary goal of excision, and local recurrence is one measure to evaluate the efficacy of surgical technique. OBJECTIVE To compare published local recurrence rates for melanoma treated with Mohs micrographic surgery (MMS) or staged excision versus wide local excision (WLE). METHODS AND MATERIALS Search of 6 databases identified comparative and noncomparative studies that reported local recurrence rates after MMS, staged excision, or WLE for melanoma. Random-effects meta-analysis was used to estimate odds ratios and 95% confidence interval (CI) from comparative studies and event rates from noncomparative studies. RESULTS Of the 71 studies included (16,575 patients), 12 were comparative studies (2,683 patients) and 56 were noncomparative studies (13,698 patients). Comparative studies showed increased recurrence after WLE compared with MMS or staged excision (odds ratio [OR], 2.5; 95% CI, 1.4-4.6) and compared with MMS alone (OR, 3.3; 95% CI, 1.8-5.9). Pooled data from comparative and noncomparative studies showed a local recurrence rate of 7% after WLE (95% CI, 5%-11%), 3% after staged excision (95% CI, 2%-4%), and less than 1% after MMS (95% CI, 0%-1%). Statistical heterogeneity was moderate to high. CONCLUSION Local recurrence of melanoma is significantly lower after MMS (<1%) and staged excision (3%) compared with WLE (7%).
Collapse
Affiliation(s)
| | - Christopher J Miller
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - M Hassan Murad
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota
| | | | - Jerry D Brewer
- Department of Dermatology Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
|
16
|
Kim HE, Shim HJ, Jung C, Shin IS, Kim JM, Yun SJ. Correlations of psychological distress with plasma cytokine levels and gene mutations in acral and non-acral melanoma. Front Psychiatry 2022; 13:1024206. [PMID: 36405903 PMCID: PMC9669704 DOI: 10.3389/fpsyt.2022.1024206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The presence of psychological distress has negatively affected the course and prognosis of melanoma. Psychological distress is influenced by cytokines and gene mutations, particularly in cancer, but no studies have investigated this phenomenon in melanoma patients. This study investigated the correlations of psychological distress, plasma cytokine levels, and gene mutations in melanoma patients, focusing on melanoma sites and TNM stages. METHODS This study prospectively evaluated melanoma patients who visited Chonnam National University Hwasun Hospital from September 2020 to March 2021. Melanoma sites were divided into acral and non-acral sites. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale, and quality of life was evaluated with EuroQol-5 Dimensions. Plasma cytokine levels, and depression- and cytokine-related gene mutations were analyzed. RESULTS This study included 151 melanoma patients. Anxiety was found in 14.6% of the patients, and depression in 29.8%. The melanoma sites were not significantly associated with anxiety, depression, or quality of life. However, psychological distress was significantly associated with the plasma cytokines IL-2, IL-4, IL-5, IL-10, IL-12, TNF-α and IFN-γ. COMT, SLC6A4, SLC6A3, and IL-12b gene mutations were also associated with melanoma sites and TNM stage, anxiety, and QOL. CONCLUSION Psychological distress was associated with plasma cytokine levels and depression- and cytokine-related gene mutations. Using psychiatric intervention and emotional support, cytokine levels related to melanoma can be changed, which may have positive effects on the prognosis and treatment of melanoma. More careful follow-up, evaluation, and management are needed for patients with gene mutations.
Collapse
Affiliation(s)
- Hong Euy Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyun Jung Shim
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, South Korea
| | - Chaeyong Jung
- Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
| | - Il Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| |
Collapse
|
|
17
|
Early stage melanoma diagnosis and mental health-related: emotional influence of body self-perception. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
|
18
|
Lindqvist Bagge AS, Wesslau H, Cizek R, Holmberg CJ, Moncrieff M, Katsarelias D, Carlander A, Olofsson Bagge R. Health-related quality of life using the FACT-M questionnaire in patients with malignant melanoma: A systematic review. Eur J Surg Oncol 2021; 48:312-319. [PMID: 34600786 DOI: 10.1016/j.ejso.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/20/2021] [Accepted: 09/16/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since there are no formal definition of health-related quality of life (HRQOL) there may be a lack of coherence and understanding of how to interpret HRQOL-data. The aim of this study is to summarize HRQOL-results that have used the FACT-M questionnaire in patients with melanoma, and specifically to summarize FACT-M between tumor stage. METHODS This review was conducted in accordance with the PRISMA guidelines. INCLUSION CRITERIA original studies on cutaneous melanoma between 2005 and 2020, written in English, containing "Functional Assessment of Cancer Therapy Melanoma" OR "Functional Assessment of Cancer Therapy M" OR FACT-M OR FACT/M OR FACTM OR "FACT M" OR FACT-melanoma OR "FACT Melanoma" together with FACT-M numbered data and basic patient characteristics, using the databases Scopus, Web of Science, PubMed and PsycINFO. RESULTS 16 articles describing 14 patient cohorts published 2008-2020 were included. The majority of the studies did not report subscale scores in accordance with FACT-M guidelines. The results did indicate that FACT-M total scores were inversely correlated with AJCC stage. Subscale analysis demonstrated varying degrees of correlation with AJCC stage. The Melanoma Surgery Subscale score was lowest in stage III patients, probably reflecting more advanced surgical procedures in this group of patients. CONCLUSIONS Though this review is based on a questionnaire limited to the assessment of melanoma patients, it highlights the universal need for clinical studies to describe their selected HRQOL-questionnaires, its definition of HRQOL and its dimensions, as well as comply with the questionnaire's guidelines when reporting HRQOL-data.
Collapse
Affiliation(s)
- Ann-Sophie Lindqvist Bagge
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Psychology, Gothenburg University, Gothenburg, Sweden.
| | - Hanna Wesslau
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Roza Cizek
- Department of Psychology, Gothenburg University, Gothenburg, Sweden
| | - Carl Jacob Holmberg
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Marc Moncrieff
- Department of Plastic & Reconstructive Surgery, Norfolk & Norwich University Hospital, Norwich, UK
| | - Dimitrios Katsarelias
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Anders Carlander
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; SOM Institute. University of Gothenburg, Gothenburg, Sweden
| | - Roger Olofsson Bagge
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| |
Collapse
|
|
19
|
Bittar PG, Bittar JM, Etzkorn JR, Brewer JD, Aizman L, Shin TM, Sobanko JF, Higgins HW, Giordano CN, Cohen JV, Pride R, Wan MT, Leitenberger JJ, Bar AA, Aasi S, Bordeaux JS, Miller CJ. Systematic review and meta-analysis of local recurrence rates of head and neck cutaneous melanomas after wide local excision, Mohs micrographic surgery, or staged excision. J Am Acad Dermatol 2021; 85:681-692. [PMID: 33961921 DOI: 10.1016/j.jaad.2021.04.090] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/27/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prospective trials have not compared the local recurrence rates of different excision techniques for cutaneous melanomas on the head and neck. OBJECTIVE To determine local recurrence rates of cutaneous head and neck melanoma after wide local excision (WLE), Mohs micrographic surgery (MMS), or staged excision. METHODS A systematic review of PubMed, EMBASE, and Web of Science identified all English case series, cohort studies, and randomized controlled trials that reported local recurrence rates after surgery for cutaneous head and neck melanoma. A meta-analysis utilizing a random effects model calculated weighted local recurrence rates and confidence intervals (CI) for each surgical technique and for subgroups of MMS and staged excision. RESULTS Among 100 manuscripts with 13,998 head and neck cutaneous melanomas, 51.0% (7138) of melanomas were treated by WLE, 34.5% (4826) by MMS, and 14.5% (2034) by staged excision. Local recurrence rates were lowest for MMS (0.61%; 95% CI, 0.1%-1.4%), followed by staged excision (1.8%; 95% CI, 1.0%-2.9%) and WLE (7.8%; 95% CI, 6.4%-9.3%). LIMITATIONS Definitions of local recurrence varied. Surgical techniques included varying proportions of invasive melanomas. Studies had heterogeneity. CONCLUSION Systematic review and meta-analysis show lower local recurrence rates for cutaneous head and neck melanoma after treatment with MMS or staged excision compared to WLE.
Collapse
Affiliation(s)
- Peter G Bittar
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Julie M Bittar
- Section of Dermatology, Rush University Medical Center, Chicago, Illinois
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jerry D Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Leora Aizman
- George Washington University School of Medicine, Washington, DC
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Harold W Higgins
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cerrene N Giordano
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Justine V Cohen
- Division of Hematology and Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Renee Pride
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Marilyn T Wan
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Anna A Bar
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon
| | - Sumaira Aasi
- Department of Dermatology, Stanford Medicine, Stanford, California
| | | | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
|
20
|
Mamoor M, Postow MA, Lavery JA, Baxi SS, Khan N, Mao JJ, Rogak LJ, Sidlow R, Thom B, Wolchok JA, Korenstein D. Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors. J Immunother Cancer 2021; 8:jitc-2019-000260. [PMID: 32152222 PMCID: PMC7061889 DOI: 10.1136/jitc-2019-000260] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2020] [Indexed: 01/12/2023] Open
Abstract
Background Immune checkpoint inhibitors (CIs) have revolutionized treatment of advanced melanoma, leading to an emerging population of long-term survivors. Survivors’ quality of life (QOL) and symptom burden are poorly understood. We set out to evaluate symptom burden and QOL in patients with advanced melanoma alive more than 1 year after initiating CI therapy. Methods Cross-sectional surveys, accompanied by chart review of patients with advanced melanoma treated with CIs at Memorial Sloan Kettering Cancer Center, completed therapy, and were alive >1 year after treatment initiation. Surveys were administered between February and August 2018. Surveys included: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, EuroQOL, items from Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events and Fatigue Severity Scale. Results We included 90 patients. The most common CI regimens were ipilimumab plus nivolumab (53%) and pembrolizumab (41%); most patients (71%) were not treated in clinical trials. Median time from CI therapy initiation was 40 months and from last dose was 28 months. Fatigue was reported by 28%, with higher fatigue scores in women than men; 12% reported difficulty sleeping. Aching joints (17%) and muscles (12%) were fairly common. Level of functioning was generally high. Overall QOL was excellent though 40% reported ‘some or moderate’ problems with anxiety/depression and 31% with pain/discomfort. Conclusions After CI therapy, long-surviving advanced melanoma patients commonly report fatigue but otherwise have moderate symptom burden and good QOL. Ensuring appropriate symptom management will optimize clinical outcomes for these patients.
Collapse
Affiliation(s)
- Maha Mamoor
- Health Outcomes Group, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michael A Postow
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jessica A Lavery
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Niloufer Khan
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jun J Mao
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lauren J Rogak
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robert Sidlow
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Bridgette Thom
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jedd A Wolchok
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Deborah Korenstein
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
|
21
|
Cross-sectional study of sex differences in psychosocial quality of life of long-term melanoma survivors. Support Care Cancer 2021; 29:5663-5671. [PMID: 33580285 DOI: 10.1007/s00520-021-06046-7] [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: 10/13/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE A cancer diagnosis and subsequent treatment can have a significant impact on an individual's quality of life. Differences in quality of life by sex among long-term melanoma survivors remain unclear. The objective of this study was to describe sex differences in cancer-specific psychosocial quality of life of long-term melanoma survivors. METHODS Melanoma survivors 7-10 years post-diagnosis from a previously conducted population-based case-control study were recruited for a cross-sectional survey. Validated measures of psychosocial quality of life related to melanoma diagnosis were assessed. Outcomes were compared by sex using linear regression models adjusting for age, education, income, and marital status. RESULTS The survey response rate was 62% (433 females, 291 males; 86% stage I disease). Females were more likely to report changes in their appearance (p = 0.006) and being more fearful of recurrence (p = 0.001) or a second melanoma (p = 0.001) than males but were also more likely to report that melanoma had a positive impact on their lives (p < 0.0001). Males were more likely to agree with statements that emphasized that life's duration is limited (p < 0.0001). CONCLUSION Long-term melanoma survivors reported generally favorable measures of psychosocial quality of life related to their diagnosis. Females and males reported unique quality of life concerns and may require varied methods of support following a melanoma diagnosis.
Collapse
|
|
22
|
Ilie G, Rutledge R, Sweeney E. An Examination of the Role of Socioeconomic Status in the Relationship between Depression and Prostate Cancer Survivorship in a Population-Based Sample of Men from Atlantic Canada. Oncology 2021; 99:260-270. [PMID: 33486485 DOI: 10.1159/000512444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/20/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Prostate and skin cancer are among the most prevalent forms of cancer among men and have favorable survival rates compared to other, more aggressive forms of cancers. Recent studies have shown that the odds of depression among men with a lifetime history of prostate cancer are higher compared to men without a lifetime history of prostate cancer. Here we extend previous findings and examine the role of socioeconomic status in the relationship between depression and cancer survivorship status in a population-based sample of men from Atlantic Canada. METHODS A cross-sectional analysis was conducted on a subsample of 6,585 male participants aged 49-69 years from the 2009-2015 survey cycle of the Atlantic PATH study. The primary outcome was screening positive for mild, moderate or severe depression using the Patient Health Questionnaire (PHQ-9). The main predictor variable was cancer survivorship status (the presence of a lifetime history of prostate cancer, skin cancer, forms of cancer other than prostate or skin cancer, or absence of a lifetime cancer diagnosis). Covariates included age, education, marital status, household income, province, ethnicity, comorbidity, and survivorship time. RESULTS An estimated 14.7% of men in this sample screened positive for mild, moderate or severe depression. Men with a history of prostate cancer were 2.60 (95% CI: 1.02, 6.65) times more likely to screen positive for depression than men with a history of any other form of cancer. The odds ratios were 10.23 (95% CI: 2.82, 37.49) or 4.00 (95% CI: 1.20, 13.34) times higher for survivors of prostate or skin cancer who reported a low household income to screen positive for depression compared to men with a history of any other form of cancer and high household income. CONCLUSIONS These results extend current evidence of the association between prostate cancer survivorship and depression compared with men who never had a history of cancer diagnosis by indicating that this association still stands when the survivors of prostate cancer are compared to survivors of any other form of cancer, and further indicates that this association is moderated by household income. The findings highlight the importance of delivering mental health screening and support to prostate cancer survivors during the cancer journey, especially those with low household incomes.
Collapse
Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada, .,Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada, .,Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada,
| | - Robert Rutledge
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ellen Sweeney
- Atlantic PATH, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
|
23
|
Boekhout AH, Rogiers A, Jozwiak K, Boers-Sonderen MJ, van den Eertwegh AJ, Hospers GA, de Groot JWB, Aarts MJB, Kapiteijn E, ten Tije AJ, Piersma D, Vreugdenhil G, van der Veldt AA, Suijkerbuijk KPM, Rozeman EA, Neyns B, Janssen KJ, van de Poll-Franse LV, Blank CU. Health-related quality of life of long-term advanced melanoma survivors treated with anti-CTLA-4 immune checkpoint inhibition compared to matched controls. Acta Oncol 2021; 60:69-77. [PMID: 32924708 DOI: 10.1080/0284186x.2020.1818823] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Checkpoint inhibitors have changed overall survival for patients with advanced melanoma. However, there is a lack of data on health-related quality of life (HRQoL) of long-term advanced melanoma survivors, years after treatment. Therefore, we evaluated HRQoL in long-term advanced melanoma survivors and compared the study outcomes with matched controls without cancer. MATERIAL AND METHODS Ipilimumab-treated advanced melanoma survivors without evidence of disease and without subsequent systemic therapy for a minimum of two years following last administration of ipilimumab were eligible for this study. The European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC QLQ-C30), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Melanoma questionnaire (FACT-M) were administered. Controls were individually matched for age, gender, and educational status. Outcomes of survivors and controls were compared using generalized estimating equations, and differences were interpreted as clinically relevant according to published guidelines. RESULTS A total of 89 survivors and 265 controls were analyzed in this study. After a median follow-up of 39 (range, 17-121) months, survivors scored significantly lower on physical (83.7 vs. 89.8, difference (diff) = -5.80, p=.005), role (83.5 vs. 90, diff = -5.97, p=.02), cognitive (83.7 vs. 91.9, diff = -8.05, p=.001), and social functioning (86.5 vs. 95.1, diff = -8.49, p= <.001) and had a higher symptom burden of fatigue (23.0 vs. 15.5, diff = 7.48, p=.004), dyspnea (13.3 vs. 6.7, diff = 6.47 p=.02), diarrhea (7.9 vs. 4.0, diff = 3.78, p=.04), and financial impact (10.5 vs. 2.5, diff = 8.07, p=.001) than matched controls. Group differences were indicated as clinically relevant. DISCUSSION Compared to matched controls, long-term advanced melanoma survivors had overall worse functioning scores, more physical symptoms, and financial difficulties. These data may contribute to the development of appropriate survivorship care.
Collapse
Affiliation(s)
- A. H. Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A. Rogiers
- Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - K. Jozwiak
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - M. J. Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - G. A. Hospers
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - M. J. B. Aarts
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E. Kapiteijn
- Leiden University Medical Centre, Leiden,The Netherlands
| | - A. J. ten Tije
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | - D. Piersma
- Medical Spectrum Twente, Enschede,The Netherlands
| | - G. Vreugdenhil
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven,The Netherlands
| | | | - K. P. M. Suijkerbuijk
- Department of Medical Oncology, University Medical Cancer Center, Utrecht, The Netherlands
| | - E. A. Rozeman
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - B. Neyns
- Universitair Ziekenhuis Brussel, Brussel, Belgium
| | | | - L. V. van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C. U. Blank
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| |
Collapse
|
|
24
|
Park JH, Chun M, Bae SH, Kim HJ. Research Trends on Factors Influencing the Quality of Life of Cancer Survivors: Text Network Analysis and Topic Modeling Approach. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.4.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jin-Hee Park
- Professor, College of Nursing · Research Institute of Nursing Science Ajou University, Suwon, Korea
| | - Mison Chun
- Professor, School of Medicine, Ajou University, Suwon, Korea
| | - Sun Hyoung Bae
- Associate Professor, College of Nursing · Research Institute of Nursing Science Ajou University, Suwon, Korea
| | - Hee-Jun Kim
- Doctoral Student, College of Nursing, Ajou University, Nurse, Ajou University Hospital, Suwon, Korea
| |
Collapse
|
|
25
|
Joshy G, Thandrayen J, Koczwara B, Butow P, Laidsaar-Powell R, Rankin N, Canfell K, Stubbs J, Grogan P, Bailey L, Yazidjoglou A, Banks E. Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC Med 2020; 18:372. [PMID: 33256726 PMCID: PMC7708114 DOI: 10.1186/s12916-020-01830-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. METHODS Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes-severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)-in participants with versus without cancer, for 13 cancer types. RESULTS Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25-1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02-1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24-1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56-3.77; distress 1.53, 1.20-1.96; poor/fair QoL 2.40, 1.87-3.07), lung cancer (disability 2.81, 2.50-3.15; distress 1.67, 1.46-1.92; poor/fair QoL 2.53, 2.21-2.91) and non-Hodgkin's lymphoma (disability 1.56, 1.37-1.78; distress 1.20, 1.05-1.36; poor/fair QoL 1.66, 1.44-1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16-1.32; distress 0.95, 0.90-1.01; poor/fair QoL 1.15, 1.05-1.25), prostate cancer (disability 1.11, 1.04-1.19; distress 1.09, 1.02-1.15; poor/fair QoL 1.15, 1.08-1.23) and melanoma (disability 1.02, 0.94-1.10; distress 0.96, 0.89-1.03; poor/fair QoL 0.92, 0.83-1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. CONCLUSIONS Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.
Collapse
Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Bogda Koczwara
- Flinders University and Flinders Medical Centre, Adelaide, SA, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Laidsaar-Powell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Rankin
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Karen Canfell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | | | - Paul Grogan
- Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia
| | - Louise Bailey
- Primary Care Collaborative Cancer Clinical Trials Group Community Advisory Group, Melbourne, VIC, Australia.,Psycho-oncology Cooperative Research Group Community Advisory Group, Camperdown, NSW, Australia
| | - Amelia Yazidjoglou
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.,Sax Institute, Haymarket, NSW, Australia
| |
Collapse
|
|
26
|
Lisy K, Lai-Kwon J, Ward A, Sandhu S, Kasparian NA, Winstanley J, Boyle F, Gyorki D, Lacey K, Bishop J, Jefford M. Patient-reported outcomes in melanoma survivors at 1, 3 and 5 years post-diagnosis: a population-based cross-sectional study. Qual Life Res 2020; 29:2021-2027. [PMID: 32140919 DOI: 10.1007/s11136-020-02464-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE There is a lack of population-based data describing patient reported outcomes (PROs) in melanoma survivors which could guide the development of interventions and resources. This study assessed overall quality of life (QoL), self-reported symptoms and unmet information needs in melanoma survivors 1, 3 or 5 years post-diagnosis. METHODS A cross-sectional postal survey was conducted in Victoria, Australia, with eligible melanoma survivors identified from a population-based cancer registry. Patient-reported outcome measures included the EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and self-reported symptoms, difficulties and information needs. Associations between demographic, disease and care-related factors and QoL were also assessed. RESULTS A total of 476 melanoma survivors participated in the study (response rate 46.5%). Anxiety and depressive symptoms were more prevalent in survivors compared to the general population (30.7% vs 21.6%; p < 0.01). Fear of cancer recurrence (48.3%) and fear of cancer spreading (37.8%) were the most commonly reported symptom items, and approximately one in five melanoma survivors had unmet information needs related to psychological aspects of living with melanoma. Recurrent melanoma, living in a nursing home, chronic comorbidities, and melanoma diagnosed at > 2 mm thickness were associated with lower QoL. CONCLUSION A large proportion of melanoma survivors reported ongoing quality of life deficits, fear of cancer recurrence, as well as unmet information needs up to 5 years after diagnosis. Patients may benefit from tailored informational resources and interventions that address the psychological aspects of living with and beyond melanoma.
Collapse
Affiliation(s)
- Karolina Lisy
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Australian Cancer Survivorship Centre, a Richard Pratt Legacy, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
| | - Julia Lai-Kwon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Andrew Ward
- The Social Research Centre, Melbourne, VIC, Australia
| | - Shahneen Sandhu
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Nadine A Kasparian
- Cincinnati Children's Center for Heart Disease and the Developing Mind, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Julie Winstanley
- Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, University of Sydney, Sydney, NSW, Australia
| | - Frances Boyle
- Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, University of Sydney, Sydney, NSW, Australia
| | - David Gyorki
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Karen Lacey
- Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Jim Bishop
- Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Michael Jefford
- Australian Cancer Survivorship Centre, a Richard Pratt Legacy, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
|
27
|
Living with leg lymphedema: developing a novel model of quality lymphedema care for cancer survivors. J Cancer Surviv 2020; 15:140-150. [PMID: 32712757 PMCID: PMC7822774 DOI: 10.1007/s11764-020-00919-2] [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: 05/08/2020] [Accepted: 07/10/2020] [Indexed: 11/03/2022]
Abstract
Purpose Lower-extremity lymphedema (LEL) is a lifelong consequence of cancer therapy and can lead to serious physical and psychosocial complications for many cancer survivors. However, clinical knowledge and treatment of LEL remain minimal. The purpose of this study was to integrate perspectives of lymphedema patients and healthcare providers (HCPs) on LEL to develop a novel model for quality lymphedema care. Methods A mixed-methods approach was implemented. Standardized questionnaires and semi-structured interviews were used to assess psychosocial well-being and experiences of LEL patients. Interviews were also used to evaluate the clinical experiences of HCPs working within tumour groups associated with cancer-related LEL. Thematic analysis was used to analyse qualitative data. Results Twenty-two patients and eleven HCPs participated in this study. Patient QOL, generalized anxiety and depressive symptom scores revealed a complex interplay between psychosocial well-being and supportive LEL care after cancer. Three themes emerged from interviews with patients (n = 19) and HCPs (n = 11): level of lymphedema knowledge, effectiveness of rehabilitation oncology services and barriers to care. Implications for Cancer Survivors We developed a novel model for quality lymphedema care that emphasizes the importance of continued physical and psychosocial support for LEL patients, while illustrating the importance of HCPs in facilitating a smooth transition for patients to LEL care after cancer treatment. Electronic supplementary material The online version of this article (10.1007/s11764-020-00919-2) contains supplementary material, which is available to authorized users.
Collapse
|
|
28
|
Butner-Kozimor LM, Savla J. Couples Facing Skin Cancer in Old Age: A Dyadic Investigation of Partner Support and Quality of Life. Int J Aging Hum Dev 2020; 93:746-766. [PMID: 32715770 DOI: 10.1177/0091415020940193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated perceived support received by partners and its association with quality of life (QOL) in older couples facing skin cancer. Thirty couples (n = 60; M Age = 70) in which one partner had a skin cancer diagnosis (PwSC) completed either online or paper surveys about their skin cancer diagnosis, perceived partner support, and overall QOL. Actor-partner interdependence models revealed that when PwSCs reported overprotection from their healthy partners (HPs), they were more likely to report lower QOL. Protective buffering received by HPs was negatively associated with their QOL as well as their PwSCs QOL. Active engagement support, however, was not associated with either partner's QOL. While couples may use all three styles of relationship-focused support, protective buffering and overprotection affected each partner's QOL. Implications of the study findings for interventions for couples facing illnesses like skin cancer are discussed.
Collapse
Affiliation(s)
| | - Jyoti Savla
- 184761 Department of Human Development and Family Science, Virginia Tech, Blacksburg, USA.,1757 Center for Gerontology, Virginia Tech, Blacksburg, USA
| |
Collapse
|
|
29
|
Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, Rutkowski N, Ta V, Trudel G, Laflamme SZ, Lavigne AA, Dinkel A. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One 2020; 15:e0234124. [PMID: 32716932 PMCID: PMC7384626 DOI: 10.1371/journal.pone.0234124] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses. METHODS We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained. RESULTS There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features. CONCLUSIONS The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
Collapse
Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Christina Tomei
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Georden Jones
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicole Rutkowski
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Ta
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Trudel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
|
30
|
Vollmann M, Engelhardt G, Salewski C. Effects of a brief multimodal online intervention on the intention to conduct sun protective behaviours through targeting illness representations about skin cancer: a randomized controlled trial. Psychol Health 2020; 36:253-270. [PMID: 32524850 DOI: 10.1080/08870446.2020.1775831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: The incidence of skin cancer can be reduced by increasing sun protective behaviours. Based on the Common-Sense Model and the Intervention Mapping approach, a brief intervention targeting illness representations about skin cancer to increase the intention to conduct sun protective behaviours was developed and evaluated regarding its effectiveness.Design: A randomized pre-post control group design with 509 healthy participants (69% women, mean age 39 years).Main outcome measures: Changes in illness representations about skin cancer (emotional representations, illness coherence, and prevention control) and the intention to conduct sun protective behaviours, i.e. UV protection and sun avoidance.Results: ANCOVAs showed that the intervention increased illness coherence and perceived prevention control as well as the intention to conduct sun protective behaviours. Mediation analyses revealed that the increase in illness coherence and/or perceived prevention control partially mediated the effect of the intervention on the increase of the intention to use UV protection (indirect effects: .02*, .06*) and to avoid sun exposure (indirect effects: .01 ns, .04*).Conclusion: The intervention was successful in changing illness representations and thereby increasing the intention to conduct sun protective behaviours. The findings provide evidence for the usefulness of the Common-Sense Model in the context of illness prevention.
Collapse
Affiliation(s)
- Manja Vollmann
- Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Gabriela Engelhardt
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| |
Collapse
|
|
31
|
Zöller D, Wockner LF, Binder H. Automatic variable selection for exposure-driven propensity score matching with unmeasured confounders. Biom J 2020; 62:868-884. [PMID: 32203625 DOI: 10.1002/bimj.201800190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 11/06/2022]
Abstract
Multivariable model building for propensity score modeling approaches is challenging. A common propensity score approach is exposure-driven propensity score matching, where the best model selection strategy is still unclear. In particular, the situation may require variable selection, while it is still unclear if variables included in the propensity score should be associated with the exposure and the outcome, with either the exposure or the outcome, with at least the exposure or with at least the outcome. Unmeasured confounders, complex correlation structures, and non-normal covariate distributions further complicate matters. We consider the performance of different modeling strategies in a simulation design with a complex but realistic structure and effects on a binary outcome. We compare the strategies in terms of bias and variance in estimated marginal exposure effects. Considering the bias in estimated marginal exposure effects, the most reliable results for estimating the propensity score are obtained by selecting variables related to the exposure. On average this results in the least bias and does not greatly increase variances. Although our results cannot be generalized, this provides a counterexample to existing recommendations in the literature based on simple simulation settings. This highlights that recommendations obtained in simple simulation settings cannot always be generalized to more complex, but realistic settings and that more complex simulation studies are needed.
Collapse
Affiliation(s)
- Daniela Zöller
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Center of Data Analysis and Modelling, Mathematical Institute - Faculty of Mathematics and Physics, University of Freiburg, Freiburg, Germany
| | - Leesa F Wockner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Center of Data Analysis and Modelling, Mathematical Institute - Faculty of Mathematics and Physics, University of Freiburg, Freiburg, Germany
| |
Collapse
|
|
32
|
Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in "chronic" cancer survivors: a meta-analysis. J Cancer Surviv 2020; 14:504-517. [PMID: 32162194 DOI: 10.1007/s11764-020-00869-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. METHODS A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. RESULTS Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. CONCLUSION QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.
Collapse
Affiliation(s)
- Jenny Firkins
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
| | - Lissi Hansen
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Martha Driessnack
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Nathan Dieckmann
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.,Division of Clinical Psychology, Oregon Health & Science University, 3314 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| |
Collapse
|
|
33
|
Guarino A, Polini C, Forte G, Favieri F, Boncompagni I, Casagrande M. The Effectiveness of Psychological Treatments in Women with Breast Cancer: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9010209. [PMID: 31940942 PMCID: PMC7019270 DOI: 10.3390/jcm9010209] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/14/2022] Open
Abstract
Breast cancer is the most prevalent oncological disease among women, and it represents the second oncological cause of death. Many studies have considered the quality of life in people with breast cancer because this condition has high comorbidity with mental distress, anxiety, affective disorders and depression. Psychological interventions can reduce the stressful consequences of both the diagnosis and the medical treatments of breast cancer. However, different methods (e.g., group or individual therapy) and focus (e.g., improving personal skills or increasing emotional well-being) do not help to identify which type of psychological therapy can be more effective in improving quality of life in patients with breast cancer. This study was aimed to systematically review and compare, by means of a meta-analysis, the efficacy of cognitive behavioural, supportive-expressive or psycho-educational treatments in women with breast cancer, focusing on anxiety, depression, mood and quality of life as outcomes. The PRISMA statement was adopted. MEDLINE, PsycINFO, PUBMED and PsycArticles databases were used, and reference lists were examined for additional publications. In the selection of the articles were included studies considering women between 18 and 65 years who were diagnosed with breast cancer at any stage and under any treatment, and who underwent psychological group interventions. At the end of the systematic review, 45 studies met all inclusion criteria and were analysed in the meta-analysis. The overall effect size was medium, especially considering cognitive behavioural therapy and psycho-educational treatments. However, the studies are characterised by high methodological heterogeneity. Despite some limitations, this review and meta-analysis partially confirm the efficiency of cognitive-behavioural and psycho-educational therapies in the improvement of well-being in women with breast cancer.
Collapse
Affiliation(s)
- Angela Guarino
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.F.); (F.F.)
- Correspondence:
| | - Cristina Polini
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (C.P.); (I.B.); (M.C.)
| | - Giuseppe Forte
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.F.); (F.F.)
| | - Francesca Favieri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.F.); (F.F.)
| | - Ilaria Boncompagni
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (C.P.); (I.B.); (M.C.)
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (C.P.); (I.B.); (M.C.)
| |
Collapse
|
|
34
|
Health-related quality of life, emotional burden, and neurocognitive function in the first generation of metastatic melanoma survivors treated with pembrolizumab: a longitudinal pilot study. Support Care Cancer 2019; 28:3267-3278. [DOI: 10.1007/s00520-019-05168-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/31/2019] [Indexed: 12/19/2022]
|
|
35
|
Kandel M, Dalle S, Bardet A, Allayous C, Mortier L, Dutriaux C, Guillot B, Leccia M, Dalac S, Legoupil D, Saiag P, Montaudie H, Arnault J, Brunet‐Possenti F, Grob J, DeQuatrebarbes J, Beylot‐Barry M, Lesimple T, Aubin F, Maubec E, Granel‐Brocard F, Stoebner P, Dupuy A, Dreno B, Michiels S, Lebbe C, Borget I. Quality‐of‐life assessment in French patients with metastatic melanoma in real life. Cancer 2019; 126:611-618. [DOI: 10.1002/cncr.32554] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/10/2019] [Accepted: 08/21/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Marguerite Kandel
- Biostatistics and Epidemiology Service Gustave Roussy Institute Villejuif France
- Center for Research in Epidemiology and Population Health University of Paris‐Saclay University of Paris‐Sud, and Versailles‐Saint‐Quentin‐en‐Yvelines University French Institute of Health and Medical Research (INSERM) Villejuif France
| | - Stéphane Dalle
- Dermatology Unit, Cancer Research Center of Lyon Lyon University HospitalClaude Bernard University Lyon France
| | - Aurélie Bardet
- Biostatistics and Epidemiology Service Gustave Roussy Institute Villejuif France
- Center for Research in Epidemiology and Population Health University of Paris‐Saclay University of Paris‐Sud, and Versailles‐Saint‐Quentin‐en‐Yvelines University French Institute of Health and Medical Research (INSERM) Villejuif France
| | - Clara Allayous
- Dermatology Unit Clinical Investigation Center Public Hospital of Paris (AP‐HP)INSERM Unit 976, Paris Diderot University‐Saint‐Louis Hospital Paris France
| | - Laurent Mortier
- ONCO‐THAI INSERM Unit 1189, Lille University, Lille Hospital Lille France
| | | | | | | | | | | | - Philippe Saiag
- Dermatology Unit Ambroise Pare HospitalAP‐HP Boulogne‐Billancourt France
| | | | | | | | | | | | | | | | | | - Eve Maubec
- Dermatology Unit Avicennes HospitalAP‐HP Paris France
| | | | | | - Alain Dupuy
- Dermatology Unit Rennes Hospital Rennes France
| | | | - Stefan Michiels
- Biostatistics and Epidemiology Service Gustave Roussy Institute Villejuif France
- Center for Research in Epidemiology and Population Health University of Paris‐Saclay University of Paris‐Sud, and Versailles‐Saint‐Quentin‐en‐Yvelines University French Institute of Health and Medical Research (INSERM) Villejuif France
| | - Céleste Lebbe
- Dermatology Unit, Cancer Research Center of Lyon Lyon University HospitalClaude Bernard University Lyon France
| | - Isabelle Borget
- Biostatistics and Epidemiology Service Gustave Roussy Institute Villejuif France
- Center for Research in Epidemiology and Population Health University of Paris‐Saclay University of Paris‐Sud, and Versailles‐Saint‐Quentin‐en‐Yvelines University French Institute of Health and Medical Research (INSERM) Villejuif France
- Research Group in Law and Health Economics University Paris‐Sud Paris France
| |
Collapse
|
|
36
|
Sira N, Lamson A, Foster CL. Relational and Spiritual Coping Among Emerging and Young Adult Cancer Survivors. J Holist Nurs 2019; 38:52-67. [PMID: 31535901 DOI: 10.1177/0898010119874983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer presents uncertainties for individuals of any age; however, emerging and young adults (EYA) are challenged to cope with developmental tasks in addition to cancer-related stressors. Guided by the double ABC-X model and biopsychosocial-spiritual framework, the current study investigates coping strategies used by this population and the role of psychological resources (perception of parental care/control and spirituality) on their coping ability. Recruited from online social media, 210 EYA cancer survivors self-reported demographic, medical information, and completed the Brief Cope scale. In addition, spirituality reliance, perceived parental care, and parental control were measured and examined in relation to coping ability. While nearly half of participants experienced positive adaptation in relation to multiple stressors, hierarchical multiple regression revealed the developmental nature of coping and indicated that higher spirituality reliance and higher degree of parental care were predictive of adaptive coping among EYA cancer survivors. Content analyses of the open-ended questions confirmed these results. In order to facilitate adaptive coping, attention must be paid to the unique biopsychosocial-spiritual and developmental needs of young cancer survivors while encouraging family support and spirituality reliance as significant tools in coping. Practical recommendations for nursing support and healthcare teams are discussed.
Collapse
|
|
37
|
Tibubos AN, Ernst M, Brähler E, Fischbeck S, Hinz A, Blettner M, Zeissig SR, Weyer V, Imruck BH, Binder H, Beutel ME. Fatigue in survivors of malignant melanoma and its determinants: a register-based cohort study. Support Care Cancer 2019; 27:2809-2818. [PMID: 30539313 DOI: 10.1007/s00520-018-4587-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Fatigue has found increasing attention as a debilitating and lasting condition of cancer patients. However, it has remained unclear to what degree long-term survivors of malignant melanoma suffer from fatigue. Therefore, this study aimed to determine fatigue and its link with quality of life, aftercare behavior, and mental and physical symptoms among melanoma survivors. METHODS A register-based sample of 684 long-term survivors an average of 8.4 (SD = 1.72; range 5.67-12.17) years after diagnosis was compared to 2049 participants from a representative survey by the Multidimensional Fatigue Inventory. In a hierarchical linear regression, statistical predictors for fatigue were ascertained. RESULTS Overall fatigue was not increased in melanoma survivors except for younger melanoma survivors under 40 years. As in the general population, fatigue increased with age, and it was higher in women compared to men. Fatigue was associated with decreased quality of life, reduced functioning, and increased physical and mental symptoms. Substantial predictors (30% explained variance) were higher age, additional chronic illness, self-blame, detrimental interactions and lack of social support, and also fear of recurrence. There was neither an effect of medical parameters (clinical stage, time since diagnosis) nor of participation in follow-up care. CONCLUSIONS Fatigue needs to be taken seriously in the aftercare of melanoma survivors as it is associated with multiple functional and quality of life impairments and heightened distress. Reduction of fatigue in melanoma patients should address younger survivors (under 40 years) and older survivors (over 60 years) with additional chronic illness and focus on illness coping and social support.
Collapse
Affiliation(s)
- Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Sabine Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Maria Blettner
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
- Cancer Registry of Rhineland Palatinate, Mainz, Germany
| | - Sylke R Zeissig
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
- Cancer Registry of Rhineland Palatinate, Mainz, Germany
| | - Veronika Weyer
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
| | - Barbara H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Harald Binder
- Faculty of Medicine and Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics (IMBI), Freiburg im Breisgau, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| |
Collapse
|
|
38
|
Ringdal GI, Ringdal K. Cancer and depression: A comparison of cancer victims with the general population, findings from the European Social Survey 2014. Scand J Public Health 2019; 47:504-510. [PMID: 28823218 DOI: 10.1177/1403494817727161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: An increasing number of people in Europe are living with cancer, either as an active disease or as a past experience. Depressive symptoms may impair quality of life in cancer patients and may constitute increased risks for disability, as well as being a risk factor for increased mortality. Our study compared self-reported symptoms of depression in people who currently or previously have experienced cancer with self-reported symptoms of depression in the general population. Methods: Our study was based on data from the European Social Survey 2014, with representative samples from 19 countries. Depression was measured by an eight-item CES-D Scale, with a cut-point of a mean score of 2 to indicate depression. Multilevel modelling was used to examine the relationship between cancer status and depression. Results: Respondents who at the time of the interview reported to have cancer were more likely to report symptoms above the cut-point on the depression scale than people who never had experienced cancer (unadjusted odds ratio (ORunadjusted)=2.59; 95% confidence interval (CI) 2.20-3.06; and ORadjusted=2.00; 95% CI 1.70-2.36). The difference was smaller comparing people who previously had experienced cancer to people who never had experienced cancer (ORunadjusted=1.46; 95% CI 1.19-1.79; and ORadjusted=1.28; 95% CI 1.05-1.55). The differences in depression by cancer status did not vary among the welfare state regimes. Conclusions: Respondents with a cancer disease showed a substantial elevated risk of depression after adjusting for a range of potential confounders. Respondents who had recovered also showed significantly higher adjusted risk of depression than respondents who had never experienced cancer.
Collapse
Affiliation(s)
| | - Kristen Ringdal
- 2 Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Norway
| |
Collapse
|
|
39
|
Long-Term Survival, Quality of Life, and Psychosocial Outcomes in Advanced Melanoma Patients Treated with Immune Checkpoint Inhibitors. JOURNAL OF ONCOLOGY 2019; 2019:5269062. [PMID: 31182961 PMCID: PMC6512024 DOI: 10.1155/2019/5269062] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
Immune checkpoint inhibitors have become a standard of care option for the treatment of patients with advanced melanoma. Since the approval of the first immune checkpoint (CTLA-4) inhibitor ipilimumab in 2011 and programmed death-1 (PD-1) blocking monoclonal antibodies pembrolizumab and nivolumab thereafter, an increasing proportion of patients with unresectable advanced melanoma achieved long-term overall survival. Little is known about the psychosocial wellbeing, neurocognitive function, and quality of life (QOL) of these survivors. Knowledge about the long term side-effects of these novel treatments is scarce as long-term survivorship is a novel issue in the field of immunotherapy. The purpose of this review is to summarize our current knowledge regarding the survival and safety results of pivotal clinical trials in the field of advanced melanoma and to highlight potential long-term consequences that are likely to impact psychosocial wellbeing, neurocognitive functioning, and QOL. The issues raised substantiate the need for clinical investigation of these issues with the aim of optimizing comprehensive health care for advanced melanoma survivors.
Collapse
|
|
40
|
Chernyshov PV, Lallas A, Tomas-Aragones L, Arenbergerova M, Samimi M, Manolache L, Svensson A, Marron SE, Sampogna F, Spillekom-vanKoulil S, Bewley A, Forsea AM, Jemec GB, Szepietowski JC, Augustin M, Finlay AY. Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer. J Eur Acad Dermatol Venereol 2019; 33:816-827. [PMID: 30963614 DOI: 10.1111/jdv.15487] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer (NMSC) present a review of the literature and position statement on health-related (HR) QoL assessment in skin cancer patients. A literature search was carried out to identify publications since 1980 that included information about the impact of SC on QoL. Generic, dermatology-specific, cancer-specific, SC-specific, facial SC-specific, NMSC-specific, basal cell carcinoma-specific and melanoma-specific QoL questionnaires have been used to assess HRQoL in SC patients. HRQoL was assessed in the context of creation and validation of the HRQoL instruments, clinical trials, comparison of QoL in SC and other cancers, other diseases or controls, HRQoL assessment after treatment, comorbidities, behaviour modification, predictors of QoL and survival, supportive care needs, coping strategies and fear of cancer recurrence. The most widely used instruments for HRQoL assessment in SC patients are the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), the Functional Assessment of Cancer Therapy-Melanoma (FACT-M), Skin Cancer Index (SCI), Short Form 36 Item Health Survey (SF-36) and the Dermatology Life Quality Index (DLQI). The TFs recommend the use of the cancer-specific EORTC QLQ-C30, especially in late stages of disease, and the melanoma-specific FACT-M and SC-specific SCI questionnaires. These instruments have been well validated and used in several studies. Other HRQoL instruments, also with good basic validation, are not currently recommended because the experience of their use is too limited. Dermatology-specific HRQoL instruments can be used to assess the impact of skin-related problems in SC. The TFs encourage further studies to validate HRQoL instruments for use in different stages of SC, in order to allow more detailed practical recommendations on HRQoL assessment in SC.
Collapse
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Samimi
- Dermatology Department, University of Tours, Tours, France
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM, Rome, Italy
| | - S Spillekom-vanKoulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - A M Forsea
- Department of Oncologic Dermatology and Allergology, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
|
41
|
The rule of 10s versus the rule of 2s: High complication rates after conventional excision with postoperative margin assessment of specialty site versus trunk and proximal extremity melanomas. J Am Acad Dermatol 2018; 85:442-452. [PMID: 30447316 DOI: 10.1016/j.jaad.2018.11.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/25/2018] [Accepted: 11/03/2018] [Indexed: 01/01/2023]
Abstract
Specialty site melanomas on the head and neck, hands and feet, genitalia, and pretibial leg have higher rates of surgical complications after conventional excision with postoperative margin assessment (CE-POMA) compared with trunk and proximal extremity melanomas. The rule of 10s describes complication rates after CE-POMA of specialty site melanomas: ∼10% risk for upstaging, ∼10% risk for positive excision margins, ∼10% risk for local recurrence, and ∼10-fold increased likelihood of reconstruction with a flap or graft. Trunk and proximal extremity melanomas encounter these complications at a lower rate, according to the rule of 2s. Mohs micrographic surgery (MMS) with frozen section melanocytic immunostains (MMS-I) and slow Mohs with paraffin sections decrease complications of surgery of specialty site melanomas by detecting upstaging and confirming complete tumor removal with comprehensive microscopic margin assessment before reconstruction. This article reviews information important for counseling melanoma patients about surgical treatment options and for developing consensus guidelines with clear indications for MMS-I or slow Mohs.
Collapse
|
|
42
|
Krajewski C, Benson S, Elsenbruch S, Schadendorf D, Livingstone E. Predictors of quality of life in melanoma patients 4 years after diagnosis: Results of a nationwide cohort study in Germany. J Psychosoc Oncol 2018; 36:734-753. [PMID: 30321123 DOI: 10.1080/07347332.2018.1499691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In this multicenter, cross-sectional study, 561 melanoma patients completed a questionnaire battery 4 years after primary diagnosis. The proportion of melanoma patients with clinically relevant anxiety (p < .001) or depression (p = .001) symptoms was significantly greater compared to the general population. Lower QoL was predicted by higher depression (ß = -.329, p < .001) and anxiety (ß = -.257, p < .001), older age (ß = -.147, p = .002), and body mass index (ß = -.093, p = .036). Clinical parameters including tumor stage and comorbidity index did not enter the model. Overall, the model explained 32.2% of total variance (F = 43.66, p < .001, corrected R2 = .322). The proportion of patients with clinically relevant anxiety symptoms requires attention. Anxiety and depression symptoms contribute to impaired QoL, calling for appropriate screening.
Collapse
Affiliation(s)
- Christin Krajewski
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Sven Benson
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Sigrid Elsenbruch
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Dirk Schadendorf
- b Department of Dermatology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Elisabeth Livingstone
- b Department of Dermatology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| |
Collapse
|
|
43
|
Damato B, Hope-Stone L, Cooper B, Brown SL, Salmon P, Heimann H, Dunn LB. Patient-reported Outcomes and Quality of Life After Treatment of Choroidal Melanoma: A Comparison of Enucleation Versus Radiotherapy in 1596 Patients. Am J Ophthalmol 2018; 193:230-251. [PMID: 29555484 DOI: 10.1016/j.ajo.2018.03.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To test the hypothesis that patients treated with radiotherapy for choroidal melanoma enjoy better quality of life (QoL) than patients who have undergone enucleation. METHODS In this nonrandomized study, patients with choroidal melanoma treated at the Royal Liverpool University Hospital, Liverpool, UK, were invited to complete QoL questionnaires approximately 6 months postoperatively and then on each anniversary of their primary treatment. These instruments consisted of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OPT30 questionnaire, Hospital Anxiety & Depression Scale, and the Functional Assessment of Cancer Treatment questionnaire. Patient-reported outcomes were correlated with demographics, ocular treatment, social factors, presenting tumor and ocular status, self-reported general health, marital status, and employment status. RESULTS The 1596 patients were treated with radiotherapy (72.3%) or enucleation (27.7%). Enucleation was associated with male sex (χ2, P = .004), older age (t test, P < .001), larger tumor diameter (t test, P < .001), monosomy 3 (χ2, P < .001), depression (linear regression, 95% confidence interval [CI], .17 to 1.01), and reduced physical and functional well-being (linear regression, 95% CI, -1.14 to -0.12 and -1.96 to -0.47), respectively. Poor QoL was attributed to the ocular disease by 21% and 20% of enucleated and irradiated patients, respectively (χ2, P = .938). CONCLUSIONS Patient-reported outcomes and QoL were worse in patients who had undergone primary enucleation for choroidal melanoma. These outcomes may partly have been caused by factors predisposing to enucleation rather than enucleation itself, because enucleated patients tended to be older, with more advanced disease at presentation, and a worse prognosis for survival. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
Collapse
|
|
44
|
Fischbeck S, Weyer-Elberich V, Zeissig SR, Imruck BH, Blettner M, Binder H, Beutel ME. Determinants of illness-specific social support and its relation to distress in long-term melanoma survivors. BMC Public Health 2018; 18:511. [PMID: 29665805 PMCID: PMC5904995 DOI: 10.1186/s12889-018-5401-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/04/2018] [Indexed: 12/13/2022] Open
Abstract
Background Social support is considered to be one of the most important resources for coping with cancer. However, social interactions may also be detrimental, e. g. disappointing or discouraging. The present study explored: 1. the extent of illness-specific positive aspects of social support and detrimental interactions in melanoma survivors, 2. their relationships to mental health characteristics (e. g. distress, quality of life, fatigue, coping processes, and dispositional optimism) and 3. Combinations of positive social support and detrimental interactions in relation to depression and anxiety. Methods Based on the cancer registry of Rhineland-Palatinate, Germany, melanoma patients diagnosed at least 5 years before the survey were contacted by their physicians. N = 689 melanoma patients filled out the Illness-specific Social Support Scale ISSS (German version) and standardised instruments measuring potential psychosocial determinants of social support. Results Using principal component analysis, the two factor structure of the ISSS could be reproduced with acceptable reliability; subscales were “Positive Support” (PS) and “Detrimental Interactions” (DI); Cronbach’s α = .95/.72. PS was rated higher than DI. Multivariable linear regressions identified different associations with psychosocial determinants. Survivors living in a partnership and those actively seeking out support had a higher probability of receiving PS, but not DI. PS and DI interacted regarding their association with distress: Survivors reporting high DI but low PS were the most depressed and anxious. High DI was partly buffered by PS. When DI was low, high or low PS made no difference regarding distress. Conclusion Psycho-oncologic interventions should take into account both positive and negative aspects of support in order to promote coping with the disease.
Collapse
Affiliation(s)
- Sabine Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Saarstr 21, D-55099, Mainz, Germany.
| | - Veronika Weyer-Elberich
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | - Barbara H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Maria Blettner
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
|
45
|
Tran A, Fogarty G, Nowak A, Espinoza D, Rowbotham N, Stockler M, Morton R. A systematic review and meta-analysis of utility estimates in melanoma. Br J Dermatol 2018; 178:384-393. [DOI: 10.1111/bjd.16098] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 12/19/2022]
Affiliation(s)
- A.D. Tran
- NHMRC Clinical Trials Centre; University of Sydney; 92-94 Parramatta Road Camperdown 2050 Australia
| | - G. Fogarty
- St Vincent's Department of Radiotherapy; St Vincent's Hospital; Darlinghurst 2010 Australia
| | - A.K. Nowak
- School of Medicine and Pharmacology; University of Western Australia; Crawley 6009 Australia
- Department of Medical Oncology; Sir Charles Gairdner Hospital; Nedlands 6009 Australia
| | - D. Espinoza
- NHMRC Clinical Trials Centre; University of Sydney; 92-94 Parramatta Road Camperdown 2050 Australia
| | - N. Rowbotham
- NHMRC Clinical Trials Centre; University of Sydney; 92-94 Parramatta Road Camperdown 2050 Australia
| | - M.R. Stockler
- NHMRC Clinical Trials Centre; University of Sydney; 92-94 Parramatta Road Camperdown 2050 Australia
| | - R.L. Morton
- NHMRC Clinical Trials Centre; University of Sydney; 92-94 Parramatta Road Camperdown 2050 Australia
| |
Collapse
|
|
46
|
Lee HH, Chiu CC, Lee KT, Wang JJ, Lin JJ, Chao CM, Shi HY. Do preoperative depressive symptoms predict quality of life after laparoscopic cholecystectomy: A longitudinal prospective study. PLoS One 2018; 13:e0202266. [PMID: 30161169 PMCID: PMC6116980 DOI: 10.1371/journal.pone.0202266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 07/31/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The impact of preoperative depressive symptoms on quality of life (QOL) after laparoscopic cholecystectomy (LC) remains unclear. The purpose of this study was to develop a benchmark for capturing the burden of depressive symptoms on QOL after LC and for supporting evidence-based clinical interventions for remediating these effects. METHODS Patients diagnosed with depressive symptoms (Beck Depression Inventory score > 13) after LC (n = 336) were classified into a depressive symptoms group. Propensity score matching was then used to match them with 336 patients in a non-depressive symptoms group for all potential confounding factors. All patients completed the 36-item Short Form Health Survey (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI) at baseline and at 2 years postoperatively. The 95% confidence intervals (CIs) for differences in responsiveness estimates were derived by bootstrap estimation. RESULTS The GIQLI results revealed that the non-depressive symptoms group had relatively stronger responses for emotional impairment (4.10, 95% CI 2.81 to 5.39) and social impairment (4.06, 95% CI 2.65 to 5.46) in comparison with the depressive symptoms group. In the SF-36, the non-depressive symptoms group also had stronger responses for role emotional (12.63, 95% CI 10.73 to 14.54), social functioning (11.25, 95% CI 9.85 to 12.65), vitality (3.81, 95% CI 2.82 to 4.81), mental health (11.97, 95% CI 10.36 to 13.56) and general health (3.84, 95% CI 2.95 to 4.75). CONCLUSIONS Depressive symptoms complicate the management of LC patients and are associated with poorer outcomes. Because depressive symptoms are very common, further studies are needed to evaluate integrated and comprehensive approaches for assessing and treating these symptoms.
Collapse
Affiliation(s)
- Hao-Hsien Lee
- Department of General Surgery, Chi Mei Medical Center, Liouying, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, Chi Mei Medical Center, Liouying, Taiwan
- Department of General Surgery, Chi Mei Medical Center, Yongkang, Taiwan
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - King-Teh Lee
- Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chi-Mei Medical Center, Yongkang, Tainan, Taiwan
- Department of Psychiatry, Chi-Mei Hospital, Liouying, Tainan, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- * E-mail:
| |
Collapse
|
|
47
|
The role of depression and personality traits in patients with melanoma: a South-European study. Melanoma Res 2017; 27:625-631. [DOI: 10.1097/cmr.0000000000000380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
48
|
Zeissig SR, Weyer-Elberich V, Emrich K, Binder H, Fischbeck S, Imruck BH, Friedrich-Mai P, Beutel ME, Blettner M. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact. BMC Med Res Methodol 2017; 17:150. [PMID: 29166870 PMCID: PMC5700464 DOI: 10.1186/s12874-017-0425-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 11/14/2017] [Indexed: 11/17/2022] Open
Abstract
Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%). The cooperation proportion was 52.2% (689 participants/1320 contacted patients). Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57). However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.
Collapse
Affiliation(s)
- S R Zeissig
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany. .,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - V Weyer-Elberich
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - K Emrich
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Binder
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - S Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - B H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P Friedrich-Mai
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
|
49
|
Abstract
Most cancer survivors adjust well to life after cancer but some experience persisting negative mood, such as cancer-related fears, posttraumatic stress, anxiety, or depression. Mood fluctuations may not reach criteria for a clinical diagnosis but subclinical symptoms can interfere with quality of life. Women, adolescents, and young adults are particularly at risk for mood disturbances. Behavioral interventions, such as cognitive behavioral therapy and pharmacologic treatments, can effectively treat these distressing emotions. Much of the research on managing emotional needs after cancer has been completed with breast cancer survivors and more work is needed with diverse groups of survivors.
Collapse
Affiliation(s)
- Jean C Yi
- Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA 98109, USA
| | - Karen L Syrjala
- Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA 98109, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, 1959 NE Pacific Street, Seattle, WA 98195, USA.
| |
Collapse
|
|
50
|
Dieng M, Kasparian NA, Mireskandari S, Butow P, Costa D, Morton R, Mann G, Menzies S, Cust A. Psychoeducational intervention for people at high risk of developing another melanoma: a pilot randomised controlled trial. BMJ Open 2017; 7:e015195. [PMID: 29018064 PMCID: PMC5652456 DOI: 10.1136/bmjopen-2016-015195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Information and psychological needs have been reported as one of the greatest areas of unmet needs for patients with melanoma. To respond to these needs, we developed the Melanoma Care Intervention, a developed psychoeducational intervention for people at high risk of developing another melanoma comprising of a newly developed melanoma educational booklet and individually tailored telephone support sessions provided by trained psychologists. The purpose of this study was to investigate the acceptability and feasibility of the Melanoma Care Intervention. METHODS Twenty-four adults (14 men, 10 women, mean age: 58 years, SD: 12.2) at high risk of developing a subsequent primary melanoma were recruited and randomly assigned 1:1 to the intervention (a psychoeducational booklet, a Cancer Council booklet on melanoma and up to five telephone-based sessions with a psychologist) or usual care (Cancer Council booklet only). Acceptability, feasibility, fear of cancer recurrence and secondary psychosocial outcomes were assessed at baseline, 1 and 6 months. RESULTS Satisfaction and perceived benefits were rated highly for all intervention components, particularly the telephone-based psychology sessions (mean satisfaction and benefits: both 9.27 out of 10, SD=2.41). The quality of information and support provided throughout the trial was rated as 'high' by the intervention group, with a mean score of 4.6 out of a possible 5 (SD=0.9) and 4.2 (SD=1.2) for the control group. CONCLUSIONS The intervention was feasible and acceptable for improving psychological adjustment. Timely access to effective, evidence-based, psychological care is a recognised need for people with melanoma. The intervention is designed to directly address this need in a way that is feasible in a clinical setting, acceptable to patients and health professionals. TRIAL REGISTRATION NUMBER The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19/03/2013 (Registration Number: ACTRN12613000304730).
Collapse
Affiliation(s)
- Mbathio Dieng
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - N A Kasparian
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Shab Mireskandari
- Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney, Sydney, New South Wales, Australia
| | - Phyllis Butow
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Costa
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Rachael Morton
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - Graham Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
- Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - Scott Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney, Camperdown, Australia
- The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Anne Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
| |
Collapse
|