Fear of recurrence in long-term cancer survivors—Do cancer type, sex, time since diagnosis, and social support matter?

2016 ◽  
Vol 35 (12) ◽  
pp. 1329-1333 ◽  
Author(s):  
Lena Koch-Gallenkamp ◽  
Heike Bertram ◽  
Andrea Eberle ◽  
Bernd Holleczek ◽  
Sieglinde Schmid-Höpfner ◽  
...  
Keyword(s):  
Social Support ◽  
Cancer Survivors ◽  
Fear Of Recurrence ◽  
Cancer Type ◽  
Time Since Diagnosis

Long-term impact of chemotherapy on early stage ovarian cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5024-5024 ◽  
Author(s):  
U. A. Matulonis ◽  
A. Kornblith ◽  
H. Lee ◽  
J. Bryan ◽  
C. Gibson ◽  
...  
Keyword(s):  
Social Support ◽  
Ovarian Cancer ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Early Stage ◽  
Fear Of Recurrence ◽  
Socioeconomic Impact ◽  
Abdominal Symptoms ◽  
Early Stage Ovarian Cancer

5024 Background: Quality of life (QOL) assessments in early stage (stage I and II) ovarian cancer survivors (CS) are limited and have to date not focused on CS who have received adjuvant platinum- and taxane-based chemotherapy (CT). Methods: 55 early stage ovarian patients (pts) were identified from patient logs from the Dana-Farber Cancer Institute and Massachusetts General Hospital. 54 pts. received CT. QOL and long-term medical sequelae were measured in pts who were > 3 years from diagnosis and had no evidence of recurrent cancer. Pts were interviewed by phone, and the following surveys were administered: EORTC QLQ-C30 (EORTC) and QLQ-OV28 (OV-28), MHI-17, CALGB sexual functioning, GOG Neuropathy, FACT Fatigue, Beck’s Hopelessness, Fear of Recurrence (FOR), Dyadic Adjustment Scale (DAS), PCL-C post-traumatic stress disorder (PTSD), Unmet Needs, FACT-Spirituality (FACT-Sp), complementary therapy use, and MOS Social Support (MOS). Results: 55 pts were interviewed (mean age 58 yrs, range 34 to 77 yrs). Mean time between diagnosis and interview was 5.6 yrs. CS reported significantly higher MHI-17 scores than the population norm, and higher MHI-17 scores were associated with better overall QOL (EORTC, r = 0.57, p < 0.0001), increased social support (MOS, r = 0.54, p < 0.0001), and better marital relationships (DAS, r = 0.42, p < 0.001). Sexual problems (1.57 out of 6) and unmet needs (1.5 out of 14) were minimal. FOR was correlated with lowered overall QOL (EORTC, r = −0.63, p < 0.0001), increased abdominal symptoms (OV-28 abdominal scale, r = 0.48, p < 0.0002), increased hopelessness (Beck’s, r = 0.46, p < 0.0005), and increased spirituality (FACT-Sp, r = −0.57, p < 0.0001). CS were using 5.4 complementary therapies for QOL purposes and 5.8 for cancer treatment. Minimal negative socioeconomic impact was observed in CS (0.16 out of 4). However, 12.5% of pts had scores indicative of a diagnosis of PTSD. Conclusions: Long-term QOL follow-up of early stage ovarian cancer survivors demonstrated minimal long-term symptoms, excellent mental health, minimal unmet needs, and minimal socioeconomic impact. No significant financial relationships to disclose.

scholarly journals A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors

2021 ◽  
Author(s):  
L. M. E. van Erp ◽  
H. Maurice-Stam ◽  
L. C. M. Kremer ◽  
W. J. E. Tissing ◽  
H. J. H. van der Pal ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Psychosocial Outcomes ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Negative Impacts ◽  
Time Since Diagnosis

Abstract Purpose This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer. Methods YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses. Results YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47). Conclusion YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.

scholarly journals Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory: A Singapore Perspective

2019 ◽  
Author(s):  
Gek Phin Chua ◽  
Quan Sing Ng ◽  
Hiang Khoon Tan ◽  
Whee Sze Ong
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Cancer Survivorship ◽  
Recurrence Risk ◽  
Term Treatment ◽  
Fear Of Recurrence ◽  
Long Term Treatment

Abstract Background The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship of the cancer survivorship trajectory and to assess whether these concerns have any effect on their quality of life (QOL). The overall goal was to use the insights from the study to guide practice on patient care. Methods A cross-sectional survey of 1107 cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers from a cancer centre in Singapore. Eligible patients self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. Results The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0 – 10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue Conclusion This study confirms that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL It is critical to design patient care delivery that appropriately address the various concerns of cancer survivors in order for them to cope and improve their QOL.

Fear of recurrence in long-term testicular cancer survivors

2009 ◽  
Vol 18 (6) ◽  
pp. 580-588 ◽  
Author(s):  
Tone Skaali ◽  
Sophie D. Fosså ◽  
Roy Bremnes ◽  
Olav Dahl ◽  
Carl Fredrik Haaland ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Cancer Survivors ◽  
Fear Of Recurrence ◽  
Testicular Cancer Survivors

scholarly journals Health status, lifestyle habits, and perceived social support in long-term cancer survivors: a cross-sectional study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Beatriz León-Salas ◽  
Edurne Zabaleta-del-Olmo ◽  
Joan Llobera ◽  
Bonaventura Bolíbar-Ribas ◽  
Tomás López-Jiménez ◽  
...  
Keyword(s):  
Social Support ◽  
Health Status ◽  
Cancer Survivors ◽  
Perceived Social Support ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Lifestyle Habits ◽  
Cross Sectional

Post-traumatic stress disorder in young breast cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 202-202
Author(s):  
Danny A. Vazquez ◽  
Shoshana M. Rosenberg ◽  
Shari I. Gelber ◽  
Kathryn Jean Ruddy ◽  
Evan Morgan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Stress Disorder ◽  
Stage I ◽  
Fear Of Recurrence ◽  
Anxiety And Depression ◽  
Psychiatric Comorbidities ◽  
Young Breast Cancer

202 Background: Posttraumatic stress disorder (PTSD) is associated with morbidity and mortality in affected populations. Cancer survivors experience PTSD at a rate higher than the general population, with young age and female gender identified as risk factors. While young women with breast cancer experience greater psychosocial distress in general following diagnosis (dx), little is known about PTSD in this population. Methods: Women dx’d with Stage I-III breast cancer at age ≤ 40 were surveyed as a part of a multi-site cohort study. Demographic, treatment, psychosocial characteristics (including self-reported psychiatric conditions and use of psychiatric medications prior to dx), anxiety and depression (Hospital Anxiety and Depression Scale), fear of recurrence (Lasry Scale), and social support (Medical Outcomes Study) were assessed within 1 year after dx. PTSD was measured at 30 months post-dx using the PTSD Checklist – Civilian Version; a score ≥ 50 was considered positive for PTSD. Univariable and stepwise multivariable logistic regression were used to evaluate factors associated with PTSD. Results: 572 women were eligible for this analysis; median age at dx was 37 (range: 17-40); 87% had Stage I or II cancer. 37/572 women (6.5%) met criteria for PTSD at 30 months. Lower educational attainment, less financial comfort, less social support, stage 2 (vs. 1) disease, receipt of chemotherapy, fear of recurrence, anxiety and depression, and psychiatric comorbidities were associated (p ≤ 0.05) with PTSD in univariable analyses. Chemotherapy (OR = 3.48, 95% CI = 1.09-11.06), anxiety by HADS (OR = 20.29, 95% CI = 7.83-52.53), and psychiatric comorbidities (OR = 4.22, 95% CI = 1.40-12.74) were associated with increased likelihood of PTSD, whereas college education (OR = 0.25, 95% CI = 0.10-0.59) and greater social support (OR = 0.41, 95% CI = 0.17-0.99) appeared to be protective in multivariable analyses. Conclusions: PTSD affects a minority of young breast cancer survivors, with the prevalence in our cohort similar to that seen in other breast cancer populations. Early identification of those at risk for developing PTSD is essential for the adequate treatment of affected women and for the improvement of health outcomes and quality of life in cancer survivors.

Impact of using volumetric dosimetry to screen childhood cancer survivors for radiation-related late effects.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12066-12066
Author(s):  
Sally Cohen-Cutler ◽  
Cameron Kaplan ◽  
Arthur Olch ◽  
Kenneth Wong ◽  
Jemily Malvar ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Pure Tone ◽  
Childhood Cancer Survivors ◽  
Cancer Type ◽  
Screening Practices ◽  
Long Term Follow Up

12066 Background: Late effects screening guidelines for survivors of childhood cancer treated with radiation therapy currently use irradiated regions (IR) rather than volumetric dosimetry (VD), which more precisely identifies organs-at-risk (OAR). We recently showed that VD reduced mean number of recommended screening diagnostic imaging studies and procedures by 37.0% per patient (p<0.001).1 Here we have incorporated chemotherapy and refined volumetric dosimetry dose thresholds. Methods: This was a cross-sectional cohort study of patients (n=132) treated for cancer using computerized tomography-planned irradiation at Children’s Hospital Los Angeles from 2000-2016. For each patient, both VD and IR methods were used to determine radiation exposure to the cochlea, heart, lung, breast, and colon. Dose thresholds for VD were based on those supplied in the Children’s Oncology Group (COG) Long-Term Follow-Up Guidelines. Relevant chemotherapy exposures were recorded. Under each method, COG Long-Term Follow-Up Guidelines were applied to determine potential chemotherapy- and radiation-related late effects and their correlative screening practices (complete audiologic evaluation, pure tone audiometry, mammogram, breast MRI, echocardiogram, pulmonary functions test, and/or colonoscopy). Identified OAR were compared using Exact McNemar’s test. Total numbers of screening practices were computed using VD and IR and compared. Results: Median age at end of treatment was 10.6 years (range 1.4-20.4). The most frequent cancer type was brain tumor (45%), followed by bone and soft tissue tumor (39%) and leukemia/lymphoma (16%). Head/brain was the most commonly irradiated region (61%), followed by abdomen (22%). Anthracyclines were received by 25% of patients at < 250 mg/m2 and by 16% at ≥ 250 mg/m2. With use of VD, fewer patients were flagged for screening for each organ of interest: cochlea (-21.3%, p<0.001), heart (-22.5%, p<0.001), lung (-13.8%, p=0.219), breast (-25%, p=0.625), colon (-51.9%, p<0.001). Over the lifetime of this cohort, use of VD resulted in recommendations for 1,333 fewer pure tone audiometric tests (-21.5%), 9 fewer complete audiologic evaluations (-16.1%), 4 fewer pulmonary function tests (-13.8%), 112 fewer mammograms (-25.0%) and breast MRIs (-25.0%), 349 fewer echocardiograms (-16.1%), and 275 fewer colonoscopies (-51.9%). Conclusions: Use of VD rather than IR significantly reduces guideline-based screening for radiation-related late effects in long-term childhood cancer survivors. This work forms the basis for a comparative cost-effectiveness analysis of these two approaches. (1) Cohen-Cutler et al, Cancer Medicine, 2020.

Psychosocial Factors and Impact Of Cancer In British Long-Term Haematological Cancer Survivors

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2943-2943
Author(s):  
Ania Korszun ◽  
Shah-Jalal Sarker ◽  
Kashfia Chowdhury ◽  
Charlotte Clark ◽  
Paul Greaves ◽  
...  
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Cancer Survivors ◽  
Psychosocial Factors ◽  
Positive Impact ◽  
Medical Comorbidity ◽  
Haematological Cancer ◽  
High Level ◽  
Haematological Cancer Survivors

Abstract Background Long-term cancer survivors can experience a variety of adverse physical late effects of cancer therapy. However, psychological, e.g. depression and anxiety, and social problems can also have profoundly adverse effects on patients’ quality of life (QOL) that may not be adequately addressed in the management of long-term survivors. This study examines the effect and interaction of several disease-related, social and psychological factors on QOL in 718 British long-term haematological cancer survivors (5-40 years), who had all been treated at a single centre over 50 years. Objectives (1) to measure the prevalence of psychological distress (depression, anxiety), functioning, and fatigue in this survivor group compared to rates in the UK population and other survivor groups, (2) to investigate the effect of cancer and cancer treatment on QOL and psychological and social functioning, (3) to identify psychosocial factors associated with poorer QOL outcome. Patients and Methods Ethical approval obtained from the National Research Ethics Service Ref: 11/NE/0095 All patients, aged ≥18 years at time of entry into study, with a confirmed diagnosis of haematological malignancy and alive ≥5 years since initial diagnosis, and who had received treatment at St. Bartholomew’s Hospital, London (n=1,279) were sent a questionnaire comprising questions on physical health and validated psychosocial, functional and QOL scales, including negative and positive impact of cancer (IOC). Responses were received from 718 (response rate = 56%) patients (280 Hodgkin’s Lymphoma (HL), 326 Non-Hodgkin’s lymphoma (NHL) [109 Diffuse Large B- Lymphoma (DLBCL), 128 Follicular Lymphoma (FL), 89 other NHL (ONHL)], and 112 Acute Leukaemia (AL)). Statistical Analysis QOL measures were compared to normal population and other cancer survivor groups. Two separate hierarchical regression analyses were conducted to examine the combined association of the disease type, socio-demographics, psychological and other factors, including cancer recurrence, on negative and positive IOC scores respectively. Results Survivors had poorer QOL than the general population and 15% had levels of psychological distress indicative of a clinical depressive disorder, 18% high levels of fatigue and 10% moderate to severe impairment in functioning; all these groups showed poorer QOL. There were no statistically significant differences in psychological distress (P=0.76), fatigue levels (P=0.23) or levels of functioning (P=0.74) across different cancer diagnostic groups. Higher Negative IOC scores were significantly associated (P<0.001) with the presence of medical comorbidity, depression, low or medium level of social support, a high level of fatigue and functional impairment. Greater age at diagnosis and number of years since diagnosis were significantly (P<0.001) associated with less negative IOC. Higher positive impact scores were associated with an AL diagnosis (P=0.01) ; lower positive IOC scores were associated with white ethnicity (P<0.001), a high level of education (P=0.003), not having a partner (P=0.01), depression(P=0.04), and a low level of social support (P=0.01). Conclusion The impact of cancer on survivors’ lives is influenced by a variety of factors. By using a simple means of screening for medical comorbidity, depression and fatigue the group that needs most support could be identified early, allowing appropriate interventions to improve QOL-related measures and promote well-being by addressing both negative and positive impact of cancer. Acknowledgments We are grateful for the support of Macmillan Cancer Support Greg Woolf Foundation Cancer Research UK Barts and The London NHS Trust Disclosures: No relevant conflicts of interest to declare.

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