Stigma and work discrimination among cancer survivors: A scoping review and recommendations

Background. Stigma and workplace discrimination can hinder employment opportunities for cancer survivors. Purpose. This study explored perceptions of stigma and workplace discrimination for cancer survivors to understand the impact on survivors’ engagement in paid work and to identify strategies to address stigma and workplace discrimination. Method. Using Arksey and O’Malley’s framework, we searched Medline, Embase, PsycINFO, Scopus, and CINAHL for evidence that intersected three concepts: cancer, stigma, and employment/workplace discrimination. Of the 1,514 articles initially identified, 39 met our inclusion criteria. Findings were charted, collated, and analyzed using content analysis. Findings. Myths regarding cancer (i.e., it is contagious, will always result in death) persist and can create misperceptions regarding survivors’ employability and lead to self-stigmatization. Workplace discrimination may include hiring discrimination, harassment, job reassignment, job loss, and limited career advancement. Strategies to mitigate stigma and workplace discrimination include education, advocacy, and antidiscrimination policies. Implications. Occupational therapists can enhance awareness of workplace concerns and advocate on behalf of cancer survivors.

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Graves' disease and radioiodine therapy

Nuklearmedizin ◽

10.3413/nukmed-0145 ◽

2008 ◽

Vol 47 (04) ◽

pp. 153-166 ◽

Cited By ~ 10

Author(s):

I. Weber ◽

W. Eschner ◽

F. Sudbrock ◽

M. Schmidt ◽

M. Dietlein ◽

...

Keyword(s):

Success Rate ◽

Thyroid Function ◽

Therapeutic Dose ◽

Radioiodine Therapy ◽

Antithyroid Drugs ◽

Graves Disease ◽

Inclusion Criteria ◽

End Point ◽

Point Measure ◽

The Impact

SummaryAim: This study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: A total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: Relief from hyperthyroidism was achieved in 96 % of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p=0.22). Conclusion: Thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy.

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Physical activity in patients with rheumatoid arthritis - an agile lifelong behaviour: a qualitative meta-synthesis

RMD Open ◽

10.1136/rmdopen-2021-001635 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001635

Author(s):

Emma Swärdh ◽

Christina Opava ◽

Nina Brodin

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Web Of Science ◽

Body Awareness ◽

Main Theme ◽

Inclusion Criteria ◽

Online Databases ◽

Taking Action ◽

The Impact

BackgroundPhysical activity (PA) in rheumatoid arthritis (RA) is considered a cornerstone in the treatment. To highlight aspects involved in supporting a positive PA behaviour, it is important to understand the patients’ perceptions of the phenomenon.ObjectiveThe aim of this qualitative meta-synthesis was to explore and synthesise patient perceptions of PA in RA.MethodsA purposeful search was conducted across three online databases (PubMed, CINAHL and Web of Science). The methodological quality of the included studies was appraised, and data were extracted and analysed using an interpretive inductive thematic synthesis.ResultsFifteen studies met the inclusion criteria and were included. PA was identified as an agile lifelong behaviour, with one main theme: The disease as a persistent catalyst for or against PA illustrating how the constant presence of the disease itself underlies the entire process of a life with or without regular PA. Seven subthemes: ‘considering aggravated symptoms’, ‘acknowledging the impact on health’, ‘becoming empowered and taking action’, ‘keeping informed to increase awareness’, ‘creating body awareness’, ‘dealing with social support’ and ‘feeling satisfied with circumstances and achievements’ were interpreted as facilitators and/or challenges.ConclusionThis synthesis has identified PA as an agile lifelong behaviour in which the disease pervades all aspects of an individuals’ perception of PA. Placed in a theoretical context, our findings outline a model for tailoring PA support to the drivers and determinants of a certain individual, which will improve clinical practice for the benefit of both health professionals and patients with RA.

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Validation of questionnaire-reported chest wall abnormalities with a telephone interview in Swiss childhood cancer survivors

BMC Cancer ◽

10.1186/s12885-021-08425-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rahel Kasteler ◽

Christa Lichtensteiger ◽

Christina Schindera ◽

Marc Ansari ◽

Claudia E. Kuehni ◽

...

Keyword(s):

Risk Factors ◽

Cancer Survivors ◽

Childhood Cancer ◽

Chest Wall ◽

Daily Life ◽

Well Being ◽

Childhood Cancer Survivors ◽

Thoracic Wall ◽

Medical Attention ◽

The Impact

Abstract Background Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors. Methods We investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors. Results Forty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors. Conclusion It is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.

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Long-Term Employment Outcomes among Female Cancer Survivors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082751 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2751 ◽

Cited By ~ 2

Author(s):

Christine C. Ekenga ◽

Eunsun Kwon ◽

BoRin Kim ◽

Sojung Park

Keyword(s):

Cancer Survivors ◽

Employment Status ◽

The United States ◽

Employment Outcomes ◽

Hours Worked ◽

Professional Workers ◽

Working Age ◽

The Impact ◽

Female Cancer Survivors

Advances in early detection and treatment have led to a growing population of female cancer survivors, many of whom are of working age. We examined the relationship between cancer and long-term (>5 years) employment outcomes in a nationally representative sample of working-age women in the United States. Data from nine waves of the Health and Retirement Study were used to examine employment status and weekly hours worked among cancer survivors (n = 483) and women without cancer (n = 6605). We used random slope regression models to estimate the impact of cancer and occupation type on employment outcomes. There was no difference in employment status between cancer survivors and women without cancer at baseline; however, during follow-up, cancer survivors were more likely to be employed than women without cancer (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.11–1.58). Among 6–10-year survivors, professional workers were less likely (OR = 0.40, 95% CI: 0.21–0.74) to be employed than manual workers. Among >10-year survivors, professional workers averaged fewer weekly hours worked (−2.4 h, 95% CI: −4.4–−0.47) than manual workers. The impact of cancer on long-term employment outcomes may differ by occupation type. Identifying the occupation-specific mechanisms associated with the return to work will be critical to developing targeted strategies to promote employment in the growing female cancer survivor population.

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DIPG-25. KETOGENIC DIET IN DIFFUSE INTRINSIC PONTINE GLIOMA IN CHILDREN: A RETROSPECTIVE STUDY INVESTIGATING THE FEASIBILITY

Neuro-Oncology ◽

10.1093/neuonc/noaa222.074 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii291-iii292

Author(s):

Alexandre Perez ◽

Janak Nathan ◽

Moatasem El-Ayadi ◽

Christian Korff ◽

Marc Ansari ◽

...

Keyword(s):

Ketogenic Diet ◽

Controlled Trial ◽

Diffuse Intrinsic Pontine Glioma ◽

Inclusion Criteria ◽

Pontine Glioma ◽

Randomized Controlled ◽

Small Patient Population ◽

Small Patient ◽

The Impact ◽

Aggressive Clinical Behavior

Abstract PURPOSE Diffuse Intrinsic Pontine Glioma (DIPG) is one of the most devastating diseases amongst children with cancer, thus novel strategies are urgently needed. We aimed to retrospectively evaluate the feasibility of the carbohydrate restricted ketogenic diet (KD) in DIPG patients. METHODS Searches of MEDLINE and Embase identified four publications meeting the inclusion criteria (diagnosis of DIPG and exposition to a KD ≥ 3 months). One additional case was identified by contact with experts. The minimal feasibility criteria were defined as the ability to use the KD for ≥ 3 months. Individual patient data were extracted from the publications or obtained from investigators. RESULTS Five patients (males, n=3; median age 4.4 years; range, 2.5–17 years) met the inclusion criteria (one patient – identified and not included - was on KD < 3 months due to disease progression). Further feasibility analyses showed a duration of the KD of ≥ 3 months and less than 7 months (n=2), > 7 months and less than 1 year (n= 2), and two years (n=1), respectively. CONCLUSION These results – based on a small patient population – suggest that the KD appears to be a feasible treatment option for children with DIPG. The potential duration of the KD is limited by the aggressive clinical behavior of DIPG. The safety analysis is currently being retrospectively assessed. These data should encourage further studies on a larger scale; ideally assessing the impact of the KD in DIPG patients in a randomized controlled trial.

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The impact of cognitive impairment on self‐regulatory styles in breast cancer survivors

Psycho-Oncology ◽

10.1002/pon.5633 ◽

2021 ◽

Author(s):

Jacqueline H. Becker ◽

Charlotte Ezratty ◽

Nusrat Jahan ◽

Mita Goel ◽

Yael Tobi Harris ◽

...

Keyword(s):

Breast Cancer ◽

Cognitive Impairment ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Regulatory Styles ◽

The Impact

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Albumin Utilization in Spontaneous Bacterial Peritonitis

Journal of Pharmacy Practice ◽

10.1177/0897190021997002 ◽

2021 ◽

pp. 089719002199700

Author(s):

Alex M. Ebied ◽

Thakul Rattanasuwan ◽

Yiqing Chen ◽

Adonice P. Khoury

Keyword(s):

High Risk ◽

Spontaneous Bacterial Peritonitis ◽

Total Bilirubin ◽

Kidney Injury ◽

Inclusion Criteria ◽

Dosing Regimen ◽

Bacterial Peritonitis ◽

Risk Patients ◽

The Impact ◽

Order Set

Background: Albumin has been shown to decrease the incidence of mortality and acute kidney injury (AKI) in patients with spontaneous bacterial peritonitis (SBP). Albumin administration in SBP is recommended within 6 hours of diagnosis and for reserved use in high-risk patients with the following baseline laboratory tests: serum creatinine >1 mg/dL, blood urea nitrogen >30 mg/dL or total bilirubin >4 mg/dL. Objective: We aimed to assess the impact of an albumin order set restricted to high-risk SBP. Methods: A retrospective cohort study was conducted between Jan 1, 2013 to Feb 28, 2018. The albumin order set was implemented on Sep 20, 2016. Patients were included if they were diagnosed with SBP and had an ascitic fluid polymorphonuclear count ≥ 250 cells/mm3. Results: Out of a total of 137 patients reviewed, 88 met the inclusion criteria. The incidence of AKI in the pre-order set and post-order set were 63.93% and 33.33% (p = 0.01), respectively. The incidence of mortality in the pre-order set and post-order set were 36.07% and 7.41% (p = 0.005), respectively. The percentage of patients administered albumin within 6 hours were 24.59% to 40.74% (p = 0.14) in the pre-order set and post-order set, respectively. The percentage of patients who received the recommended albumin dosing regimen ordered was 42.62% vs 96.30% (p < 0.001), in the pre-order set and post-order set, respectively. Conclusion: The albumin order set restricted to high-risk SBP patients significantly reduced the incidence of AKI and mortality, and improved the appropriateness of albumin regimen ordered.

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Psychosocial Interventions Situated Within the Natural Environment with Young People Who Have Experienced Trauma: A Scoping Review

The British Journal of Social Work ◽

10.1093/bjsw/bcaa093 ◽

2020 ◽

Author(s):

Jennifer Boddy ◽

Maddy Slattery ◽

Jianqiang Liang ◽

Hilary Gallagher ◽

Amanda Smith ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Scoping Review ◽

Natural Environment ◽

Psychosocial Interventions ◽

Database Search ◽

Inclusion Criteria ◽

Clinical Change ◽

Social Work Interventions ◽

The Impact

Abstract The natural environment is increasingly used in therapeutic psychosocial interventions for young people who have experienced trauma. However, as the research in this area has yet to be synthesised, very little is known about the types and outcomes of interventions. This prevents the optimisation of social work interventions in outdoor settings. Consequently, a scoping review of peer-reviewed research published from 2008 to 2018 was undertaken to examine how nature is being used in psychosocial interventions with young people aged ten to twenty-four years who have experienced trauma and the impact of these interventions on young people’s mental health. The database search identified 5,425 records; however, only ten papers met the inclusion criteria. These papers suggested that positive changes across a range of mental health outcomes for young people were achieved in psychosocial interventions which were situated in, or made use of the natural environment, although it is unclear whether the environment influenced the outcomes. The scoping review also highlighted the need for conducting further research that examines how environmental factors contribute to clinical change for young people who have experienced trauma.

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Randomized Exercise Trial of Aromatase Inhibitor–Induced Arthralgia in Breast Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.1547 ◽

2015 ◽

Vol 33 (10) ◽

pp. 1104-1111 ◽

Cited By ~ 145

Author(s):

Melinda L. Irwin ◽

Brenda Cartmel ◽

Cary P. Gross ◽

Elizabeth Ercolano ◽

Fangyong Li ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Strength Training ◽

Aerobic Exercise ◽

Usual Care ◽

Repeated Measures ◽

Joint Pain ◽

Breast Cancer Survivors ◽

Pain Scores ◽

The Impact

Purpose Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity. Patients and Methods Eligibility criteria included receiving an AI for at least 6 months, reporting ≥ 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point. Results Over 12 months, women randomly assigned to exercise (n = 61) attended 70% (± standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (± SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001). Conclusion Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.

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Quality of Life Among Disease-Free Survivors of Rectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2004.03.137 ◽

2004 ◽

Vol 22 (2) ◽

pp. 354-360 ◽

Cited By ~ 153

Author(s):

Philippe Rauch ◽

Joelle Miny ◽

Thierry Conroy ◽

Lionel Neyton ◽

Francis Guillemin

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Cancer Survivors ◽

German Population ◽

European Organization ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact ◽

Disease Free

Purpose To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer. Patients and Methods One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument. Results Patients reported less pain (P = .002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P = .0005 and P = .002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P = .005), with less anxiety (P = .008) and higher self-esteem (P = .0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL. Conclusion QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.

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