The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

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Malaysian Northern Region Cancer Support Effort: Education and Empowerment - Building Hope, Strengthening Lives

Journal of Global Oncology ◽

10.1200/jgo.18.92700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 229s-229s

Author(s):

C.E. Oon ◽

G. Kaur ◽

H. Zulyardain ◽

A. Hassan ◽

A. Abdullah

Keyword(s):

Alternative Medicine ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Public Awareness ◽

Cultural Beliefs ◽

Well Being ◽

Diagnosis And Treatment ◽

Awareness Campaigns ◽

Cancer Support ◽

The Impact

Background: The agenda of the United Nations Sustainable Development Goals (SDGs) calls for unanimous actions to end poverty, battle against inequalities, protect the earth and to promote inclusive well-being. Today, the impact of cancer on societies threatens the ambitions of the SDGs. In developing nations, public awareness campaigns often focus on controlling the spread of communicable diseases, overlooking the rise of cancer afflictions. As a nation of multiethnic populations with different cultural and educational backgrounds, the views pertaining cancer treatment in Malaysia are often hampered by cultural beliefs. Cancer is often linked to bad luck or black magic, particularly among rural communities. The lack of knowledge in diagnostics and cancer therapeutics, in addition to many firm believers in alternative medicine may contribute to late detection and treatment only at the advanced stages of cancer. Aim: This project aims to tap into the pool of skills and expertise of the staff at the Universiti Sains Malaysia (USM) to help educate and raise public awareness on cancer causes, diagnosis and treatment among cancer survivors and the general public. Methods: My role as a scientist is to ensure that my research addresses the key problems faced in cancer therapies and that this information trickles down to the less informed traditional societies who have very different perceptions toward modern medicine. Workshops on cancer awareness highlighting cancer causes and treatment options, cancer diagnosis and holistic approaches while living with cancer were organized in partnership with MAKNA National Cancer Council Malaysia between the years 2015-2017. Support groups led by MAKNA, were also organized in a bid to educate cancer survivors who may lack important knowledge which could impinge on daily informed decisions concerning cancer diagnosis and treatment. Results: Through working hand in hand with MAKNA, a nonprofit organization with a duty 'to pool and use every effort, expertise and welfare from every faction of society to fight cancer', this project has successfully drawn knowledge and expertise from USM staff to come together as one to raise awareness and support cancer survivors. Members have also traveled to remote regions of Malaysia for home visits and cancer group meetings to support the cancer survivors and to raise awareness. Cancer survivors have been able to obtain personal advice from the university's cancer pathologist on their diagnosis, and have their queries answered pertaining to western medicine vs alternative medicine from academic research point of view. Conclusion: Working together with MAKNA has enabled cancer researchers and university staff to relate to real-life adversities so that we can continue to translate our research and knowledge to benefit the society.

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The Person I Used To Be: Employment Experiences of Young Adults with Cancer

10.21203/rs.3.rs-97313/v1 ◽

2020 ◽

Author(s):

Melissa C. Scardaville ◽

Kathleen M. Murphy ◽

Marla Clayman ◽

Rhonda Robert ◽

Sandra Medina-George ◽

...

Keyword(s):

Young Adults ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Structured Interviews ◽

Career Trajectory ◽

Short Term ◽

Young Adult Cancer Survivors ◽

Adult Cancer Survivors ◽

Young Adult Cancer ◽

The Impact

Abstract Purpose: Adults can experience employment-related hardships after a cancer diagnosis but young adults at the beginning of their careers may face unique challenges. This study explored the impact of cancer on young adults’ employment experiences. Methods: The authors conducted 27 qualitative semi-structured interviews with young adults who had received a cancer diagnosis. Results: Participants encountered mixed workplace support. Many reported that they did not have the benefits, such as time off or short-term disability insurance, that would have ameliorated some challenges encountered during treatment. They also shared that many workplaces do not do an adequate job of informing people with cancer about federal laws that protect people with disabilities. Most participants reported that the cancer diagnosis and treatment caused them to rethink their career trajectory.Conclusions: Cancer affects young adults in ways that present distinct struggles attributable to less access to resources. Career choices and the consequent opportunities for on-the-job training can have lifelong import.Implications for Cancer Survivors: Disability and discrimination laws do not protect all employees. Young adult cancer survivors may need to conduct their own research into these protections so they can receive entitled benefits. They and employers may also benefit from workplace interventions or trainings to lessen the employment consequences of cancer.

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Impact of a cancer diagnosis on the income of adult cancer survivors: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2020-047315 ◽

2021 ◽

Vol 11 (9) ◽

pp. e047315

Author(s):

Shiraz El Adam ◽

Colene Bentley ◽

Lisa McQuarrie ◽

Paulos Teckle ◽

Stuart Peacock

Keyword(s):

Cancer Survivors ◽

Cancer Diagnosis ◽

Scoping Review ◽

Productivity Loss ◽

Health Science ◽

Future Research ◽

Scoping Reviews ◽

Adult Cancer Survivors ◽

Review Protocol ◽

The Impact

IntroductionWhile the socioeconomic impact of a cancer diagnosis on cancer survivors has gained some attention in the literature, to our knowledge, a review of the evidence on changes in income due to cancer has yet to be undertaken. In this paper, we describe a scoping review protocol to review the evidence on the effect of a cancer diagnosis on the income of individuals diagnosed with cancer during adulthood (≥18 years). The purpose is to summarise existing evidence, identify gaps in current research and highlight priority areas for future research.Methods and analysisThis study will follow the methodological framework for conducting scoping reviews by the Joanna Briggs Institute In collaboration with a health science librarian, we developed a search strategy to be performed in Ovid MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Econ-Literature and Evidence-Based Medicine Reviews. This scoping review will search the scientific literature published in English from 1 January 2000 to 31 December 2020. Studies that measured the impact of cancer on income of adults will be eligible for inclusion. Studies exclusively focused on employment outcomes (eg, return to work, unemployment, productivity loss), financial expenditures, childhood cancer survivors and/or the caregivers of cancer survivors will be excluded. Three independent reviewers will conduct screening and extract data. Descriptive information will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews.Ethics and disseminationThis scoping review will analyse data from publicly available materials and thus does not require ethics approval. Results from this review will be disseminated through a peer-reviewed publication and/or conference presentation with the potential to identify gaps in the literature, suggest strategies for standardised terminology and provide directions for future research.

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Fertility and pregnancy in cancer survivors

Obstetric Medicine ◽

10.1177/1753495x18757816 ◽

2018 ◽

Vol 11 (3) ◽

pp. 110-115 ◽

Cited By ~ 6

Author(s):

Monica Tang ◽

Kate Webber

Keyword(s):

Cancer Survivors ◽

Cancer Diagnosis ◽

Pregnancy Outcomes ◽

Cancer Treatments ◽

Fetal Medicine ◽

Improved Outcomes ◽

Future Fertility ◽

Potential Impact ◽

The Impact ◽

Antenatal Services

Summary Cancer survivors are increasing as improvements in cancer diagnosis and treatment translate to improved outcomes. As cancer survivors in their reproductive years contemplate pregnancy, it is important to understand the impact of cancer and its treatment on fertility and pregnancy outcomes. Cancer treatments such as chemotherapy and radiotherapy can affect patients’ fertility, and strategies are available to help preserve the future fertility of survivors. The potential impact of previous cancer diagnoses and treatments on pregnancy and maternal and fetal outcomes needs to be assessed and discussed with survivors, with support from materno-fetal medicine specialists and high-risk antenatal services as needed.

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The impact of chronic comorbidities at the time of breast cancer diagnosis on quality of life, and emotional health following treatment in Canada

PLoS ONE ◽

10.1371/journal.pone.0256536 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256536

Author(s):

Jasleen Arneja ◽

Jennifer D. Brooks

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Chronic Condition ◽

Breast Cancer Survivors ◽

Emotional Health ◽

Breast Cancer Diagnosis ◽

The Impact

Introduction Advances in breast cancer screening and treatment have led to an increasing number of breast cancer survivors. The objective of this study was to determine the impact of comorbidities on self-reported quality of life (QOL) and emotional health following a breast cancer diagnosis and treatment. Methods Women with a personal history of breast cancer (N = 3,372) were identified from the cross-sectional Canadian Partnership Against Cancer (CPAC) Experiences of Cancer Patients in Transitions Survey. Multinomial (nominal) logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the relationship between burden of comorbidities and overall QOL and emotional health (very poor/poor, fair, good, very good). Results Of the 3,372 participants, 57% reported at least one chronic condition at the time of breast cancer diagnosis. As the number of chronic conditions at diagnosis increased, the odds of reporting worse quality of life and emotional health following treatment also increased. Specifically, compared to women reporting very good QOL, for each additional chronic condition, women reported significantly higher odds of reporting good (OR = 1.22, 95% CI: 1.12, 1.32), fair (OR = 1.76, 95% CI: 1.58, 1.96), or poor/very poor (OR = 2.31, 95% CI: 1.86, 2.88) QOL. Similarly, for each additional comorbidity, women reported significantly higher odds of reporting good (OR = 1.17, 95% CI: 1.07, 1.28), fair (OR = 1.63, 95% CI: 1.46, 1.82), or poor/very poor (OR = 2.17, 95% CI: 1.81, 2.60) emotional health, relative to very good emotional health. Conclusion Breast cancer survivors coping with a high comorbidity burden experience worse overall QOL and emotional health following treatment. This highlights the importance of integrating information on comorbidities into survivorship care to improve the experience and overall outcomes of patients with complex needs.

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The impact of the COVID-19 pandemic on African American cancer survivors living in metropolitan Detroit.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12129 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12129-12129

Author(s):

Jennifer Lynn Beebe-Dimmer ◽

Chrissy Lusk ◽

Julie J. Ruterbusch ◽

Tara Baird ◽

Stephanie Pandolfi ◽

...

Keyword(s):

African American ◽

High Risk ◽

Health Behaviors ◽

Cancer Survivors ◽

Medical Care ◽

Patient Population ◽

High Risk Patient ◽

Direct Result ◽

The Impact

12129 Background: COVID-19 has had profound direct and indirect effects on population health to date and long-term effects are anticipated. Vulnerabilities to the most serious consequences of infection include older age, obesity, African American race and the presence of comorbid conditions. African American cancer survivors represent a particularly high-risk group, therefore understanding the impact of the virus and our strategies to prevent its spread on this patient population is important. Methods: The Detroit Research on Cancer Survivors (ROCS) cohort is a unique effort to understand the determinants of poor outcomes in African American cancer survivors. Eligible participants were diagnosed with breast, prostate, colorectal, or lung cancer on or after 1/1/2013, or with endometrial or any other cancer before age 50 on or after 01/01/2016 and were identified through the Metropolitan Detroit Cancer Surveillance System cancer registry. To date, we have enrolled 4173 survivors. Full participation includes completion of a baseline survey, and collection of biospecimens, medical records and tumor tissue, if available. Participants are also followed annually for outcomes and changes in history. A supplemental survey focused on the impact of COVID-19 was offered to enrolled participants beginning in the spring of 2020. The results presented here include data from 890 survivors who also completed the ROCS COVID survey. Results: Nearly all ( > 99%) survivors reported some change in their daily activities in an effort to reduce the risk of infection. At the time of survey, just over 1/3 of participants reported being tested for the virus and among those, 12% reported positive results. More than 40% of survivors reported some disruption in their access to medical care. A substantial ( > 40%) proportion of survivors reported feeling anxious, depressed and/or isolated during the COVID-19 pandemic. Approximately 40% of patients reported changes in health behaviors as a direct result of the pandemic that are known to negatively affect survivorship outcomes (physical inactivity, smoking, alcohol use). Notably, 30% of survivors reported declines in physical activity and these declines were significantly associated with increased anxiety (p = 0.008), depression (p = 0.005) and poorer health-related quality of life (p < 0.001). Conclusions: The influence of the COVID-19 pandemic on African American cancer survivors has been substantial, affecting both their physical and mental health and access to needed medical care. Coupled with changes in health behaviors as a direct result of the pandemic, these factors will likely affect outcomes in this high-risk patient population making further study and interventions necessary to mitigate the long-term impact of the pandemic on cancer outcomes.

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Depression, chronic pain, and high-impact chronic pain among cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12085 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12085-12085

Author(s):

Nosayaba Osazuwa-Peters ◽

Katherine M. Polednik ◽

Nhial T. Tutlam ◽

Raymond Tait ◽

Jeffrey Scherrer ◽

...

Keyword(s):

Chronic Pain ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Smoking Status ◽

The United States ◽

Current Smoker ◽

High Impact ◽

The Past ◽

History Of ◽

The Impact

12085 Background: The majority of the 17 million individuals living with a cancer diagnosis in the United States have experienced pain, either from the disease itself or from its treatment. Pain negatively impacts psychosocial quality of life and is associated with poorer overall outcome. However, the impact of pain on daily living differ among cancer survivors, and there is a paucity of research on chronic pain, especially high-impact chronic pain (HICP) in this growing population. We estimated the prevalence of chronic pain, and HICP among cancer survivors, and described the association between depression and these outcomes. Methods: This study used data from the 2015-2017 National Health Interview Survey. Outcomes of interest were chronic pain, defined as pain on most days or every day in the past six months, and HICP, defined as chronic pain that limited life or work activities on most days or every day during the past six months. Weighted, adjusted multivariable logistic regressions estimated association between depression and chronic pain and HICP among cancer survivors, while controlling for age, gender, marital status, education, employment, health insurance, smoking status, number of doctor’s visit, general health, and comorbidities. Results: Among 49,326 survey respondents, 11.7% (n = 5,335) had a cancer diagnosis. An estimated 43.6% of cancer survivors reported chronic pain; and 19.2% reported HICP. We found an association between depression and both chronic pain and HICP in unadjusted analyses. In the adjusted models, cancer survivors depressed within the last month had more than double the odds of reporting both chronic pain (aOR = 2.32; 95% CI 1.75, 3.07) and HICP (aOR = 2.12; 95% CI 1.50, 3.01). Other factors associated with both chronic pain and HICP among cancer survivors included being a current smoker (aORchronic pain = 1.63; 95% CI 1.14, 2.34; aORHICP = 1.83; 95% CI 1.18, 2.84) and being unemployed (aORchronic pain = 1.44; 95% CI 1.10,1.90; aORHICP = 3.10; 95% CI: 2.00−4.81). Cancer survivors with ≥2 comorbidities also had 55% increased odds of reporting chronic pain (aOR = 1.55; 95% CI 1.17,2.04) compared with those without comorbidities. Conclusions: Over 40% of cancer survivors may have a history of chronic pain, and survivors reporting being depressed are significantly more likely to report both chronic pain and HICP. The association between depression and pain in cancer survivors calls for personalized management of chronic pain, especially in cancer survivors with a history of depression.

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Cancer-work management: Hourly and salaried wage women’s experiences managing the cancer-work interface following new breast cancer diagnosis

PLoS ONE ◽

10.1371/journal.pone.0241795 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241795

Author(s):

J. Kathleen Tracy ◽

Fiyinfolu Adetunji ◽

Gulam M. Al Kibria ◽

Jennifer E. Swanberg

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Breast Cancer Diagnosis ◽

Hourly Wage ◽

Women’S Experiences ◽

Women's Experiences ◽

Prospective Longitudinal ◽

The Impact ◽

Work Management

Objective The purpose of this paper is to report the baseline characteristics of EMPOWER participants—a group of newly diagnosed breast cancer survivors—and describe differences in hourly and salaried wage women’s experiences regarding cancer and work management in the three months following breast cancer diagnosis. Design and setting The EMployment and Potential Outcomes of Working through canceER (EMPOWER) project is a prospective longitudinal, mixed methods pilot study designed to evaluate how employment influences treatment decisions among women diagnosed with breast cancer. Participants were women diagnosed with new breast cancer and treated at one of two clinical sites of the University of Maryland Medical System. Women were enrolled in the study within three months of first breast cancer diagnosis. Study visits occurred every three months for one year. This paper reports data from for the baseline and three-month visit which had been completed by all enrollees. Methods Trained research personnel collected demographic information, medical history and health status, social history, employment data, cancer-related data, psychosocial adjustment, and financial wellbeing at the baseline enrollment visit. A semi-structured qualitative interview was administered at the three-month study visit to assess employment decisions and the impact of job demands, cancer care, and cancer-work fit during the three months following diagnosis. Result Fifty women with new, primary diagnosis of breast cancer were enrolled in the study. Mean age of participants was 51 years, and 46% identified their race as Black or other. The majority of women disclosed their diagnosis to their employer and nearly all maintained some level of employment during the first three to six months of treatment. Women with hourly wage jobs were similar to those with salaried wage jobs with respect to demographic and social characteristics. Women with hourly wage jobs were more likely to report working in physically demanding jobs and taking unpaid leave. They were also more likely to experience side effects that required physical restrictions at work, to leave their jobs due to demands of treatment, and to report managing cancer and work concurrently as very difficult. Women in salaried wage jobs were more likely to report falling behind or missing work and working remotely as a cancer-management strategy. Women in hourly jobs more often reported difficulty managing the competing demands of cancer and work. Conclusion While further study is needed, these results suggest that women in hourly and salaried workers reported similar experiences managing cancer and work, with a few key exceptions. These exceptions pertain to the nature of hourly-wage work. Cancer survivors employed in hourly jobs may be more vulnerable to poor employment outcomes due to limited access to paid time off and workplace flexibility, and challenges related to managing physical aspects of cancer and employment.

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Letter to the Editor: The development of knights cabin cancer retreats: a community program to engage cancer survivors’ proactive health behaviors

Applied Cancer Research ◽

10.1186/s41241-019-0083-2 ◽

2019 ◽

Vol 39 (1) ◽

Cited By ~ 1

Author(s):

Iris Lesser ◽

Erin McGowan ◽

Lisa Belanger

Keyword(s):

Health Behaviors ◽

Cancer Survivors ◽

Learning Outcomes ◽

Emotional Support ◽

Behavioral Change ◽

Health Behaviours ◽

Positive Health ◽

Charitable Organization ◽

Sleep Management ◽

Management Techniques

Abstract Purpose Cancer survivors often lack the knowledge and skills to return to positive health behaviors following a cancer diagnosis. The use of retreats may be an ideal environment for cancer survivors to learn about health behaviours while receiving social support from other survivors. Methods Knights Cabin Cancer Retreats was created as a charitable organization in 2014 and is at no cost to participants or their supporters. Elements of the retreat include guided hikes, yoga, classes on nutrition, stress, mindfulness and sleep management techniques, all with a focus on the evidence based theories of behavioral change. Results Ten retreats have been hosted across Canada to date with 137 cancer survivors and their supporters. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition and behavioral change/habit development. Conclusion Knight’s Cabin Cancer retreats are unique in their programming with a format of health education that allows for emotional support and engagement with other cancer survivors in a therapeutically natural environment.

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