IMPACT OF CANCER ON QUALITY OF LIFE & DEPRESSION AMONG CAREGIVERS

Objective: To determine the impact of cancer on quality of life and depression among caregivers. Study Design: Cross-sectional survey. Place and Duration of Study: Anmol Hospital, Lahore, from Jul 2019 to Jan 2020. Methodology: Data collected from caregivers of female cancer patients by purposive sampling technique using Standardized Questionnaire of Caregiver Assistance Scale and emotional distress was assessed by the Profile of Mood States. Data were entered into Statistical Package for Social Sciences for statistical analysis. Results: Among 110 participants (caregivers of female cancer patients) 28 (25.5%) were female while 82 (74.5%) were male caregivers. Patients other than breast cancer were 79 (71.8%), while breast cancer patients were 31 (28.2%). There was a significant association between caregiver health, quality of life and level of depression, one year ago, and at current with p-values= 0.001, 0.001 and 0.01 respectively. Conclusion: There was a negative impact on the health and quality of life of caregivers. Their health was better in the beginning but with time, their lives became more difficult.

Factors Associated With a High Motivation to Undergo Fertility Preservation in Female Cancer Patients

Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation.Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory.Results: Almost half of the sample (44.8%) declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” (i.e., the sum of the “Need for Parenthood” and “Rejection of childfree lifestyle” subscales) in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation.Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation.

Genomic Consideration in Chemotherapy-Induced Ovarian Damage and Fertility Preservation

Chemotherapy-induced ovarian damage and fertility preservation in young patients with cancer are emerging disciplines. The mechanism of treatment-related gonadal damage provides important information for targeting prevention methods. The genomic aspects of ovarian damage after chemotherapy are not fully understood. Several studies have demonstrated that gene alterations related to follicular apoptosis or accelerated follicle activation are related to ovarian insufficiency and susceptibility to ovarian damage following chemotherapy. This may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions after chemotherapy. This review highlights the importance of genomic considerations in chemotherapy-induced ovarian damage and multidisciplinary oncofertility strategies for providing high-quality care to young female cancer patients.

In Situ Gene Therapy Rescues Doxorubicin-induced Ovarian Damage via Adenovirus Mediated Sirt1 and Tgfbr2

Chemotherapy-induced ovarian damage and fertility loss have negative impacts on the quality of life for female cancer patients worldwide. Thus, we aimed to explore the feasibility and safety of gene therapy for prevention of such damage. First, we validated doxorubicin-induced ovarian damage in human and mouse ovarian tissues and identified two key genes (Sirt1 and Tgfbr2). Next, we generated AdV-Sirt1 and AdV-Tgfbr2 after vectors screening (AdV,AAV and LV) for their ability to transduce mouse ovaries. Finally, we conducted in situ ovarian injection of AdV-Sirt1 and AdV-Tgfbr2 in doxorubicin-treated mice and assessed their ovarian functions and reserves. The interventions dramatically alleviated doxorubicin-induced ovarian damage without apparently influencing the health status of their offspring. Together, our results indicate that AdV-Sirt1 and AdV-Tgfbr2 can serve as effective and safe agents for reducing doxorubicin-induced ovarian damage and also suggest that they may be potentially applicable for post-chemotherapy protection in female cancer patients.

Gender Difference in Pain Management Among Adult Cancer Patients in Saudi Arabia: A Cross-Sectional Assessment

ObjectiveTo compare gender differences in pain management among adult cancer patients in Saudi Arabia and to explore the predictors associated with attitudinal barriers of cancer patients to pain management.MethodsA descriptive cross-sectional study was conducted among 325 cancer patients from tertiary hospitals in Saudi Arabia.ResultOf the total participants, 67.4% were women (N = 219) and 32.6% were men (N = 106). The overall mean scores of the attitudinal barriers questionnaire were 49.51 ± 13.73 in men and 54.80 ± 22.53 in women. The analysis shows significant differences in scores in subscales of tolerance (men = 7.48 ± 2.37), (women = 8.41 ± 3.01) (p = 0.003) and fear of distraction in the course of treatment (men = 6.55 ± 1.34), and (women = 7.15 ± 2.63) (p = 0.008). Female patients reported a more moderate to severe level of pain than men (worst pain in last week of 7.07 ± 1.50, worst pain in last week of 5.84 ± 2.65, respectively). Splitting by gender, the significant predictor for physiology effect domains in male cancer patients includes age, marital status, employment status, monthly income, cancer type, and presence of comorbid disease (p < 0.050). Age was a significant predictor of the domains of fatalism, communication, and harmful effects (p < 0.050) among female cancer patients.ConclusionThe present study revealed significant differences between men and women with attitudinal barriers to cancer pain management. Managing pain requires the involvement of all methods in a comprehensive manner, thus unalleviated pain influences the patient’s psychological or cognitive aspect.

Twelve-Weeks of Virtual and In-Person Exercise Training Improve Static and Dynamic Balance in Female Cancer Patients

Background: Balance is important for maintaining activities of daily living and functional independence. Whether balance is improved in cancer patients after fitness training is unclear. The purpose of this study was to determine if 12-weeks of exercise improves balance and posture in female cancer patients. Methods: Thirty-eight female cancer patients were enrolled. Of the 16 patients who completed the program (mean age±SD: 65±10 years), 12 participants were novice and 4 were experienced exercisers. Six-weeks of exercise sessions were provided in-person and the remaining sessions were virtually delivered. The American College of Sports Medicine’s exercise recommendations were followed. Novice exercises received 36, 90-minute exercise sessions (3x/week) and experienced exercisers had 24, 90-minute sessions (2x/week). Posture was measured using the plumb line method and overhead squat test; balance was measured using the unipedal single leg stance and limits of stability (LOS). Body composition, cardiorespiratory fitness, muscular strength, and flexibility were also measured. Two-way repeated measures ANOVAs and Bonferroni’s multiple comparison tests were used to determine significant differences. Results: Balance on the left leg (eyes closed) and LOS with leftward excursion were significantly improved in experienced exercisers (P=0.0029), but not in the novice group (P=0.0013). Qualitative data showed that experienced exercisers had improved static and dynamic postural alignment of the lower body. Conclusions: While cardiorespiratory and muscular fitness significantly improved in the novice group, these patients did not show balance and postural improvements. Only the experienced exercisers had significant improvements in static and dynamic balance and lower body posture.

The impact of socio-demographic factors on the survival of cancer patients in Zimbabwe

We provide a survival analysis of cancer patients in Zimbabwe. Our results show that young cancer patients have lower but not significant hazard rate compared to old cancer patients. Male cancer patients have lower but not significant hazard rate compared to female cancer patients. Race and marital status are significant risk factors for cancer patients in Zimbabwe.

Gender-dependent association of TYMS-TSER polymorphism with 5-fluorouracil or capecitabine based chemotherapy toxicity

Aim: TYMS gene encodes for TS enzyme involved in 5-fluorouracil (5-FU) and capecitabine (CAP) metabolism. This study assessed the association of TYMS-TSER and 3RG>C polymorphisms with 5-FU/CAP adverse event (AE) incidence. Materials & methods: TYMS-TSER and 3RG>C polymorphisms were analyzed by use of PCR/PCR-RFLP in 313 5-FU/CAP-treated cancer patients. Results: Female TYMS-TSER 2R carriers were at increased risk for 5-FU/CAP AEs (odds ratio: 2.195; p = 0.032). 2R/2R genotype was the only factor that increased risk for delayed drug administration or therapy discontinuation (odds ratio: 5.049; p = 0.016). No other associations were found. Conclusion: TYMS-TSER 3R/2R polymorphism was associated with incidence of AEs in female cancer patients. This gender-driven association potentially implicates the ER that, in female patients, potentially regulates TS expression.