Longitudinal investigation of Distress Thermometer scores in patients with cancer.

e24200 Background: The Distress Thermometer (DT) is a tool used to evaluate distress among cancer patients. The DT can provide information for intervention recommendations such as social work, psychological, and other ancillary services. The National Comprehensive Cancer Network (NCCN) recommends recurrent use of the tool. The DT is widely used as a standard of care for an initial screening of cancer patients, but data on subsequent use is lacking. The aim of this research was to evaluate repeat DT scores in a heterogeneous cancer patient population. Methods: Clinical investigators conducted a longitudinal study of DT ratings for cancer patients receiving outpatient care at a community-based oncology subspecialty practice in a mid-sized city from 2018 to 2019. Study objectives included reviewing referrals and evaluating the relationship between the initial screening and the screening at the 6-month checkup. The Distress Thermometer was used (i.e., 0-10; zero is “no distress” and ten “extreme distress”) with scores of four or greater regarded as a signal of greater risk for patient distress. Results: The study sample included 79 patients with an average score of 4.3 and 4.0 at baseline and the 6-month screening, respectively. Patient referrals included physical and emotional therapy (n=1) or social/psychosocial worker assessment (n=26). Patients with a documented referral had a crude 1.7 (95% CI: 0.6, 3.3) greater point decrease in scores compared to patients not offered a service referral. When adjusting for baseline scores and the time between scores, referral accounted for 1% (95% CI: 0%, 14%) of variability in score changes, while baseline scores accounted for 40% (95% CI: 22%, 52%) and time accounted for 3% (95% CI: 0%, 14%). Conclusions: Study results reveal a possible decrease in higher scores from the initial screening to the 6-month check-up. Patients with a referral did not have their service utilization confirmed and this study failed to show an additional decrease in scores based on referrals when controlling for baseline score and time. Most previous research has focused on one specific cancer type. This study revealed the possible importance in understanding DT scores in a heterogenous cancer patient population. Furthermore, large scale research is needed to confirm preliminary data and further expound on distress at initial and subsequent screenings after interventions. A better understanding of this content area may function to improve future care and patient well-being.

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Hope and Mental Well Being among Male and Female Cancer Patients

International Journal of Indian Psychology ◽

10.25215/0402.126 ◽

2017 ◽

Vol 4 (2) ◽

Author(s):

Sana Fatima

Keyword(s):

Data Analysis ◽

Standard Deviation ◽

Cancer Patient ◽

Cancer Patients ◽

Well Being ◽

Study Data ◽

Male And Female ◽

Female Cancer Patients ◽

Herth Hope Index ◽

Mental Well Being

Hope and Mental well being are important for an individual’s life and same goes for the cancer patients. The aim of the present study is to see the hope and mental well being among male and female cancer patients. The hypotheses of the study was to examine that there will be no difference between male and female cancer patient on hope and on mental well being. The sample of this study included 60 subjects (30 male and 30 female subjects) selected by purposive sampling from Aligarh district of U.P. In this study two inventories were used viz., Herth Hope Index and Warwick-Edinburgh Mental well-being scale. Investigator used mean, standard deviation and t-test, and in order to draw out the results. A quantitative approach was used by the researcher to conduct this study; data collection and data analysis were done using this approach. The results of the study are that there exists no difference found between male and female cancer patients on hope, and there exist no difference between male and female cancer patients on mental well-being.

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Identification of Prion Disease-Related Somatic Mutations in the Prion Protein Gene (PRNP) in Cancer Patients

Cells ◽

10.3390/cells9061480 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1480 ◽

Cited By ~ 3

Author(s):

Yong-Chan Kim ◽

Sae-Young Won ◽

Byung-Hoon Jeong

Keyword(s):

Cancer Patient ◽

Cancer Patients ◽

Prion Protein ◽

Patient Population ◽

Somatic Mutations ◽

Protein Gene ◽

Prion Diseases ◽

Prnp Gene ◽

Prion Protein Gene ◽

Total Cancer

Prion diseases are caused by misfolded prion protein (PrPSc) and are accompanied by spongiform vacuolation of brain lesions. Approximately three centuries have passed since prion diseases were first discovered around the world; however, the exact role of certain factors affecting the causative agent of prion diseases is still debatable. In recent studies, somatic mutations were assumed to be cause of several diseases. Thus, we postulated that genetically unstable cancer tissue may cause somatic mutations in the prion protein gene (PRNP), which could trigger the onset of prion diseases. To identify somatic mutations in the PRNP gene in cancer tissues, we analyzed somatic mutations in the PRNP gene in cancer patients using the Cancer Genome Atlas (TCGA) database. In addition, to evaluate whether the somatic mutations in the PRNP gene in cancer patients had a damaging effect, we performed in silico analysis using PolyPhen-2, PANTHER, PROVEAN, and AMYCO. We identified a total of 48 somatic mutations in the PRNP gene, including 8 somatic mutations that are known pathogenic mutations of prion diseases. We identified significantly different distributions among the types of cancer, the mutation counts, and the ages of diagnosis between the total cancer patient population and cancer patients carrying somatic mutations in the PRNP gene. Strikingly, although invasive breast carcinoma and glioblastoma accounted for a high percentage of the total cancer patient population (9.9% and 5.4%, respectively), somatic mutations in the PRNP gene have not been identified in these two cancer types. We suggested the possibility that somatic mutations of the PRNP gene in glioblastoma can be masked by a diagnosis of prion disease. In addition, we found four aggregation-prone somatic mutations, these being L125F, E146Q, R151C, and K204N. To the best of our knowledge, this is the first specific analysis of the somatic mutations in the PRNP gene in cancer patients.

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Impact of yoga on quality of life for young adult noncurative cancer patients: A pilot study.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.249 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 249-249 ◽

Cited By ~ 3

Author(s):

Melanie Keats ◽

Hillary Woodside ◽

S. Nicole Culos-Reed

Keyword(s):

Quality Of Life ◽

Young Adult ◽

Side Effects ◽

Cancer Patient ◽

Cancer Patients ◽

Well Being ◽

Body Awareness ◽

Hatha Yoga ◽

Significant Difference

249 Background: A growing body of evidence is emerging to suggest that the practice of yoga can improve disease and treatment-related side effects in the non-curative cancer patient by addressing their physical, psychological, and spiritual needs. Regrettably, the literature regarding the positive benefits of yoga for the young adult (YA) non-curative cancer patient is limited. Accordingly, the purpose of this ongoing exploratory study is to examine the feasibility and safety of a 7-week home/hospice based instructive Hatha yoga intervention (Yoga Thrive - available on DVD) in non-curative, YA cancer patients. Secondary outcomes include the examination of the efficacy of yoga in mitigating cancer and treatment-related side effects through ratings of self-reported quality of life (QOL). Methods: A single-arm, non-randomized, pre and post-test, pilot investigation of a 7-week instructive home/hospice-based Hatha yoga program is currently ongoing. Pre/post program data include measures of QOL, specific to palliative disease and spiritual domains as well as open-ended measures of perceived program value. Feasibility data (e.g., recruitment, adherence, safety) are also collected. Results: To date, four YA non-curative cancer patients have participated in the 7-week yoga program. Preliminary data show a significant difference in both functional well-being (p= .047, ηp2= 0.78) and spirituality (FACIT-Sp) scores (p= 0.04, ηp2= 0.77). Although not statistically significant, a large effect in physical well-being (ηp2= 0.38); general cancer outcomes (FACT-G) (ηp2= 0.42); and palliative specific scores (ηp2= 0.62) have also emerged. Early responses to the post-program exit questions suggest that participants find the program as an opportunity for self-care, separate from traditional cancer therapies. Subjective improvements in flexibility and mindfulness (e.g., body awareness, relaxation, and calmness) have also been reported. Additionally, participants have complemented the program for its ease and flexibility of use. Conclusions: Early findings of this study provide support for the feasibility and efficacy of a home/hospice-based yoga program for YA non-curative cancer patients.

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Overall survival and complications of cancer therapy in HIV-positive cancer patients on HAART compared to HIV-negative cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.30_suppl.276 ◽

2014 ◽

Vol 32 (30_suppl) ◽

pp. 276-276

Author(s):

Kelly Ann Fritz ◽

David D. Stenehjem ◽

Stephanie A. Sanders ◽

Adam Louis Cohen

Keyword(s):

Overall Survival ◽

Cancer Therapy ◽

Febrile Neutropenia ◽

Cancer Patients ◽

Patient Population ◽

Hiv Positive ◽

Cancer Type ◽

Infection Prophylaxis ◽

Hiv Negative

276 Background: HIV-positive patients are living longer and are at higher risk for any type of cancer, not only traditional AIDS-defining cancers (ADC). This study aims to assess our overall survival rate in HIV-positive cancer patients compared to HIV-negative patients, and identify differences in complications of cancer therapy in order to ensure quality of care and outcomes in this patient population. Methods: HIV-positive patients ≥ 18 years of age with a diagnosis of cancer in the Huntsman Cancer Institute Tumor Registry from 2008-2013 were matched to HIV-negative cancer patients by cancer type, stage, age, and sex. Overall survival (OS), admission for febrile neutropenia (FN), total hospital length (LOS) of stay for any reason, and the total number of blood transfusions were assessed. Kaplan-Meier methodology was used to assess differences in cancer survival. Results: A total of 55 HIV-positive patients and 40 HIV-negative patients were included. HIV-positive patients were younger at cancer diagnosis than HIV-negative patients, 50 vs. 56 years old (p = 0.0017). A trend for reduced median OS in HIV-positive patients was observed compared to HIV-negative patients (HR 1.81; 95% CI 0.77-4.71; p = 0.1835). One-year OS was 78% for HIV-positive vs 88% for HIV-negative patients (p = 0.2673). Numerically an increased mean number of hospital admissions for FN (0.7 ± 2.0 vs. 0.4 ± 1.3; p = 0.2663), transfusions (2.5 ± 12.7 vs. 0.9 ± 2.5; p = 0.4907), and inpatient LOS (12.7 ± 23.6 vs. 7.0 ± 13.0; p = 0.2381) were observed in the HIV-positive group compared to the HIV-negative group, however this did not meet statistical significance. Conclusions: This retrospective study highlights a trend for a reduction in survival and increased FN admissions, LOS and transfusion requirements in HIV-positive patients with cancer. We have identified a need for improvement in supportive care treatments such as primary febrile neutropenia prophylaxis, opportunistic infection prophylaxis, and anemia management to improve the quality of cancer treatment in this patient population.

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The Role of Direct Oral Anticoagulants in Treatment of Cancer-Associated Thrombosis

Cancers ◽

10.3390/cancers10080271 ◽

2018 ◽

Vol 10 (8) ◽

pp. 271 ◽

Cited By ~ 20

Author(s):

Hanny Al-Samkari ◽

Jean Connors

Keyword(s):

Cancer Patient ◽

Cancer Patients ◽

Patient Population ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Population Data ◽

Standard Of Care ◽

Published Data ◽

Onset Of Action ◽

Recurrent Vte

Venous thromboembolism (VTE) complicates the clinical course of approximately 5–10% of all cancer patients. Anticoagulation of the cancer patient often presents unique challenges as these patients have both a higher risk of recurrent VTE and a higher risk of bleeding than patients without cancer. Although low molecular weight heparins (LMWH) are the standard of care for the management of cancer-associated VTE, their use requires once or twice daily subcutaneous injections, which can be a significant burden for many cancer patients who often require a long duration of anticoagulation. The direct oral anticoagulants (DOACs) are attractive options for patients with malignancy. DOACs offer immediate onset of action and short half-lives, properties similar to LMWH, but the oral route of administration is a significant advantage. Given the higher risks of recurrent VTE and bleeding, there has been concern about the efficacy and safety of DOACs in this patient population. Data are now emerging for the use of DOACs in the cancer patient population from dedicated clinical trials. While recently published data suggest that DOACs hold promise for the treatment of cancer associated VTE, additional studies are needed to establish DOACs as the standard-of-care treatment. Many such studies are currently underway. The available data for the use of DOACs in the treatment of cancer-associated VTE will be reviewed, focusing on efficacy, safety, and other considerations relevant to the cancer patient.

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NQPC-10 (Rare) Cancer patients’ unmet needs (patient-focused healthcare needs) survey

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab159.085 ◽

2021 ◽

Vol 3 (Supplement_6) ◽

pp. vi22-vi22

Author(s):

Laureline Gatellier ◽

Yuko Moue ◽

Tomohiro Matsuda

Keyword(s):

Brain Tumor ◽

Cancer Patient ◽

Cancer Patients ◽

Unmet Needs ◽

Genomic Medicine ◽

Cancer Type ◽

Rare Cancer ◽

Rare Cancers ◽

Patient Groups

Abstract Background: Rare Cancers Japan (RCJ) consists of members of 20 rare cancer patient groups and individual rare cancer patients, including the Japan Brain Tumor Alliance (JBTA), the Pediatric Brain Tumor Network, and the DIPG Symposium Organizing Committee, and aims to solve the challenges of rare cancers. RCJ, together with the National Cancer Center Japan and the Japan Federation of Cancer Patient Groups is currently conducting a survey to clarify unmet needs of patients, as a follow-up survey to surveys conducted in 2018. Since then, a major paradigm shift happened in Japan, with the advent of genomic medicine and development of new treatments. This study plans to identify the latest unmet needs of cancer patients and to clarify the differences between cancer types to provide data for the improvement of healthcare systems.Purpose: Focusing on unmet needs of cancer patients, we conduct an online questionnaire survey of a total of 1,600 cancer patients (including brain tumor patients) regarding the following endpoints (1) detection and diagnosis, (2) treatment, (3) genomic medicine (access to genetic mutation testing), (4) clinical trials, (5) necessary information, medical care and support systems and (6) quality of life. The collected information will be analyzed to clarify the needs of patients and the nature of patient-centered healthcare. Method: The survey will be administered online, including a mix of open-ended and multiple-choice questions. The total number of questions, including respondent demographics, is 38, and the time required to answer them is expected to be between 15 and 20 minutes. Data analysis will take into account cancer type of cancer, gender, age group and region of residence of the respondent.Expected results: By February 2022, the results of the survey are expected to be available, as basis of discussion to improve brain tumor treatment and follow up, from a multidisciplinary perspective.

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Quality of Life Concerns of Long-Term Lymphoma Survivors: Results of a Pilot Study.

Blood ◽

10.1182/blood.v106.11.4695.4695 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4695-4695 ◽

Cited By ~ 1

Author(s):

Jeff A. Sloan ◽

Matthew M. Clark ◽

Carol A. Janney ◽

Teresa A. Rummans ◽

Susan M. Geyer ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Patient ◽

Cancer Patients ◽

Well Being ◽

Social Pain ◽

The Mean ◽

Pilot Sample ◽

Lymphoma Survivors

Abstract Relatively little is known about the quality of life (QOL) status among long-term (5–20 year) lymphoma survivors. Using the Mayo Tumor Registry, we identified eligible patients who were 16 years or older at diagnosis, U.S. residents, first diagnosed with Hodgkin or non-Hodgkin lymphoma from 1984–1998, diagnosed and/or initially treated at Mayo Clinic Rochester, and survived for 5 to 20 years (N=2,485). In October of 2004, we mailed a 23-page survey to 95 randomly selected patients; 7 were found to be ineligible (deceased or too ill). Of the 88 remaining patients, we were able to find a correct address for 82, and 57 completed a survey for a 70% participation rate. QOL assessments included the Functional Assessment of Cancer Therapy - General (FACT-G), and a series of linear analogue self-assessment (LASA) single-item QOL measures. Results for the pilot sample were compared to normative data for each measure relating to general cancer patient populations. All scores were transformed onto a 0–100 point scale (higher score meaning higher functioning) for ease of comparison. Of the 54 patients with complete data for analysis, the mean age at survey was 60.8 years (6.3–19.9). The mean time since diagnosis was 12.0 years (6.3–19.9), and 52% had survived more than 11 years. The mean total score for the FACT-G was 89 compared to a norm of 74 for cancer patients. Higher scores were also seen in the lymphoma survivors in each of the four FACT-G subdomains (physical, social/family, emotional and functional well-being) compared to normative cancer patient populations. The global LASA QOL measure was also higher among lymphoma survivors (mean score of 82 compared to a norm of 77), and only 7% reported a global QOL score of 50 or lower, indicative of impaired QOL. Functioning among the lymphoma survivors was higher compared to general cancer patients on the mental, physical, emotional, social, pain, fatigue, financial, and legal LASA items, while functioning was similar to general cancer patients on the spiritual and support LASA items. However, scores suggestive of impaired QOL were reported by more than 10% of the patients for the social (17%), pain frequency (31%), fatigue (20%), and financial concerns (25%) items of the LASA. There were suggestive results of effect sizes indicating that smokers had lower FACT-G physical and emotional scores, and lower LASA mental and physical QOL scores, although none achieved statistical significance. In conclusion, this pilot sample of long-term lymphoma survivor patients reported having high QOL on most domains of the FACT-G and LASA relative to other cancer patient populations. There appears to be a subset of patients who experience impaired QOL and who may require further interventions, particularly in the QOL domains of social, pain, fatigue, and financial functioning. These results also suggest that awareness of smoking status may be important. Further larger studies are needed to confirm these preliminary data and to evaluate other aspects of QOL.

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Distress prevalence and associated risk factors within the urothelial cancer population.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.526 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 526-526

Author(s):

Laurel Ralston ◽

Petros Grivas

Keyword(s):

Risk Factors ◽

Bladder Cancer ◽

Cancer Patients ◽

Urothelial Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Distress Thermometer ◽

Average Score ◽

Unexpected Finding ◽

Distress Screening

526 Background: Prevalence of distress has been estimated as high as 40% in some cancer populations, but minimal literature exists regarding distress in bladder cancer patients. Distress has been linked with multiple negative clinical outcomes, with the Commission on Cancer now requiring standardized distress screening for cancer program accreditation. The purpose of this study is to identify prevalence of distress, associated clinical risk factors and psychosocial referral trends in the urothelial cancer population. Methods: This was a retrospective review of distress screening outcomes in bladder cancer patients seen in oncology outpatient clinic at an academic medical center between January 1, 2016-October 1, 2017. Established oncology patients are screened for distress every 30 days using the Patient Health Questionnaire-9 (PHQ-9) and/or the NCCN Distress Thermometer (DT). Questionnaires are completed on an electronic tablet at the time of check-in and linked to the Epic electronic medical record in real time. A data capture program was used to query screening outcomes and identify those who met the threshold scores (PHQ-9 > 8, DT > 4). Results: Of 153 patients with a primary diagnosis of bladder, 81 (53%) completed the PHQ-9 (n = 67) or NCCN distress thermometer (n = 16). The overall incidence of distress was 13.6% with an average score of 12.3 on PHQ-9 (n = 10) and 9 on DT (n = 1). Of the patients with elevated distress, there were 7 males and 4 females with an average age of 64 and 77, respectively. All were either married or widowed. Metastasis was documented in 45%. Five were on an antidepressant and only one had mood disorder previously documented in the history. Social work referral occurred for 73% of the patients. One patient had elevated distress in the 6 months subsequent to diagnosis. Of the seven now deceased patients, all had elevated distress within 6 months of death. Conclusions: At 13.6%, the prevalence of distress in urothelial cancer patients was less than that in general oncology. Metastatic disease and female gender were risk factors while documentation of a psychiatric condition was not. One unexpected finding was that all now deceased patients had endorsed elevated distress within 6 months of death.

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A patient-centric approach to improving experience in urological cancer care

Journal of Clinical Urology ◽

10.1177/2051415816664275 ◽

2017 ◽

Vol 10 (1_suppl) ◽

pp. 39-46

Author(s):

Kelsey Flott ◽

Luke Hounsome ◽

Sabine Vuik ◽

Ara Darzi ◽

Erik Mayer

Keyword(s):

Health Care ◽

Cancer Patient ◽

Patient Experience ◽

Cancer Care ◽

Patient Population ◽

Cancer Type ◽

Care Providers ◽

Urological Cancer ◽

Cluster Membership ◽

Patient Centric

Rationale: Patient experience data are often reported at the provider level rather than the patient level, meaning that providers receive an aggregate score of all patient experience scores across their service. This inflates positivity and makes it difficult for providers to use patient experience scores to tailor improvements for patients within specific sites, wards or pathways. Patients have different priorities for their urological cancer care experience, and improvement programmes should take these differences into account. A more granular understanding of different patterns of patient experience will allow health care providers to focus their improvement strategies differently based on the needs of the patient groups that utilise their services. Objective: This study examines what groups exist within the urological cancer patient population, and what are their respective priorities for patient experience improvement. Methods: Using urological cancers as a case study, this paper uses data from the UK National Cancer Patient Experience Survey to segment the patient population based on their scores for 14 domains of experience. TwoStep cluster analyses were carried out on two groups of survey respondents: those who had an operation and those who did not. These analyses identified previously unknown clusters within the two populations. Profiles were created for each cluster based on a series of demographic variables, and a regression analysis was conducted to assess the significance of each demographic variable in determining cluster membership. Results: The TwoStep analysis yielded three clusters for both the operations and non-operations groups based on how patients experienced care: Positive, Middling and Negative. Gender, age, cancer type and income significantly influenced cluster membership: women, younger and more deprived patients were more prevalent in the Negative experience cluster. Conclusion: This more nuanced understanding of the patient population and the variation in their priorities for patient experience improvement is the first step to more patient-centric improvement. It will allow services to make more meaningful and individualised changes based on the voices of patients. This is a proof of concept that can be applied broadly in health care to more effectively deliver on the patient-centred agenda.

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Trousseau’s syndrome – what is the evidence?

Thrombosis and Haemostasis ◽

10.1160/th05-10-0694 ◽

2006 ◽

Vol 95 (03) ◽

pp. 541-545 ◽

Cited By ~ 58

Author(s):

David Bergqvist ◽

Karin Wåhlander ◽

Henry Eriksson ◽

Nils Sternby ◽

Mats Ögren

Keyword(s):

Pancreatic Cancer ◽

Cancer Patients ◽

Large Scale ◽

Metastatic Cancer ◽

Cancer Site ◽

Cancer Type ◽

Lung Cancer Patients ◽

Hospital Deaths ◽

Type Site ◽

Independent Effects

SummaryDespite numerous studies documenting the association between cancer and venous thromboembolism (VTE), the reason for the excessive risk in certain cancers remains obscure. No large-scale studies have yet investigated the independent effects of cancer type,site and growth pattern.Between 1970 and 1982, 23,796 standardised autopsies were performed, representing 84% of all in-hospital deaths in an urban Swedish population.The relationship between cancer and PE was evaluated with logistic regression.The overall PE prevalence was 23%, and 10% of the population had a fatal PE. Forty-two per cent of pancreatic cancer patients had PE (OR 2.55; 95% CI 2.10–3.09) (p<0.001); gall bladder, gastric, colorectal and pulmonary adenocarcinomas were similarly independently associated with PE. In comparison with squamous cell lung cancer, patients with pulmonary adenocarcinoma had 1.65 times higher odds for PE (95% CI 1.20–2.29). Adenocarcinoma and metastatic cancer were independently associated with PE risk (OR 1.27; 95% CI 1.16 – 1.40; p<0.001, and OR 1.10;95% CI 1.01 – 1.20; p=0.024, respectively) but when controlling for cancer type and spread, pancreatic cancer was still associated with an OR of 2.10 (95% CI 1.71–2.58) of PE (p<0.001).We conclude that the risk of PE in cancer patients depends not only on the cancer site and spread but also on the histological type.The excess independent risk in pancreatic cancer is intriguing and should warrant further research.

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