Physical performance limitations and participation restrictions among cancer survivors: a population-based study

PURPOSE: Medical late effects among cancer survivors may result in impairments that limit physical performance and activities necessary for normal participation in daily life. The aim of this analysis was to estimate the prevalence of physical performance limitations and participation restrictions among recent (< 5 years since diagnosis), and long-term (> or = 5 years) cancer survivors. METHODS: Data from the 1999-2002 National Health and Nutrition Examination Survey were analyzed to compare the proportions of physical performance limitations and participation restrictions among 279 recent and 434 long-term cancer survivors, and among 9370 persons with no reported cancer history. Multivariable logistic regression was used to calculate adjusted prevalence odds ratios. RESULTS: Physical performance limitations were 1.5-1.8 times (53% versus 21%) and participation restrictions 1.4-1.6 times (31% versus 13%) more prevalent in cancer survivors than in those with no cancer history. Recent cancer history was associated with increased prevalence of physical performance limitation and participation restriction, particularly in survivors aged 40-49 years. CONCLUSIONS: Over half of the cancer survivors reported physical performance limitations; one third reported participation restrictions. Deficits were present many years following cancer diagnosis, even among survivors who were not elderly. Cancer survivors may benefit from evaluation for rehabilitation services long after treatment for their original disease.     

Health-related quality of life among breast cancer patients compared to cancer survivors and age-matched women in the general population in Vietnam

Quality of Life Research - This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to...     

Mapping Health-Related Quality of Life,Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

Patients with cancer deal with problems related to physical, psychological, social, and emotional functions. The aim was to investigate malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria in relation to health-related quality of life, anxiety, and depression in patients with head and neck cancer. This was a prospective observational research study with 273 patients followed at the start of treatment, seven weeks, and one year. Data collection included nutritional status and support, and the questionnaires: European Organization for Research and Treatment of Cancer Head and neck cancer module (EORTC QLQ-H&N35) and the Hospital Anxiety and Depression Scale (HADS). Malnutrition was defined using the GLIM criteria. The study showed that patients with malnutrition had significantly greater deterioration in their health-related quality of life at seven weeks. On a group level, health-related quality of life was most severe at this time point and some scores still implied problems at one year. Significantly, more patients reported anxiety at the start of treatment whereas significantly more patients reported depression at seven weeks. Over the trajectory of care, the need for support often varies. Psychosocial support is imperative and at the end of treatment extra focus should be put on nutritional interventions and managing treatment-related symptoms to improve nutritional status and health-related quality of life. In the long-term, head and neck cancer survivors need help to find strategies to cope with the remaining sequel.     

Adjustment to cancer in the 8 years following diagnosis: a longitudinal study comparing cancer survivors with healthy individuals

This longitudinal study examined the long-term impact of a diagnosis of cancer on physical and psychological functioning, by comparing 8-year cancer survivors (n = 206) to a randomly selected sample of similar-aged references without cancer (n = 120) in the Netherlands. Comparisons were made at three fixed points in time: 3 months (T1), 15 months (T2), and 8 years (T3) after diagnosis. The results showed that, at 8 years after diagnosis, cancer survivors and references do not differ significantly in the level of depressive symptoms, anxiety, life satisfaction, self-esteem, social support, and marital satisfaction. However, survivors reported more physical symptoms, and those with a recurrence of cancer also reported more limitations in household and social activities. Most improvements in functioning were found in the year following diagnosis. Intriguingly, we found no evidence that cancer survivors experienced more positive changes in the self, relationships, or life in general than references, even though many cancer survivors attributed these changes to the cancer experience. In the discussion, we address the role of finding positive meaning in the process of adjustment to cancer.     

Study of quality of life on rural hypertensive patients. Comparison with the general population of the same environment

A comparative study about quality of life was made in the community of Riosa-north of Spain—on two groups of subjects: one affected by hypertension (n = 115), stage I and II of WHO, and another of the general population, matched in age, sex and residence with the former group and of the same size. The subjects with loss of self-care or mobility were excluded. The quality of life was evaluated with a standardized measurement approach referring to the spheres of physical, emotional, social and sexual functions.

With this study the validation of the Spanish version of the questionnaire was made and the results obtained were found to be more or less the same as those reported by authors in other European countries of similar sociodemographic conditions. Hypertensive patients reported significant lower scores of quality of life than the general population in more than half of the dimensions explored: well-being and physical capacity, social functioning, positive mood and psychological functioning.

In conclusion, despite the many limitations inherent to this area of research, a standardized and valid measure of relevant aspects of quality of life in the general population and especially in patients with hypertension, is available in the Spanish language.     

腹腔镜胃癌根治术的手术效果观察

目的：观察腹腔镜胃癌根治术的手术效果。方法：选择2017年12月～2019年1月本院收治的胃癌患者中的70例进行研究,将患者按姓氏进行编号,分为对照组和观察组,各35例。对照组行开腹手术治疗,观察组行腹腔镜胃癌根治术治疗,对比两组手术指标、炎性因子变化情况、并发症发生率、生存质量、胃肠激素。结果：观察组手术时间、手术切口、肠蠕动恢复时间、进食时间、住院时间均短于对照组,而手术出血量少于对照组,P<0.05;治疗前,两组数据结果比较分析,差异小,P>0.05,治疗后,观察组炎性因子水平、并发症发生率低于对照组,P<0.05;观察组生存质量高于对照组,P<0.05;观察组患者的胃肠激素改善结果更优于对照组,P<0.05。结论：胃癌采用腹腔镜根治术治疗,既可改善手术指标,又能减轻炎性因子水平,减少并发症,改善胃肠激素,提高患者生存质量,提高临床应用。     

The European Cancer and Work Network: CANWON

Purpose The number of cancer survivors is rapidly growing due to improved treatment and ageing population. Almost half of cancer patients will experience a cancer diagnosis during working age when career and work-related issues play an important role. Many cancer survivors are at risk for unemployment which greatly affects their quality of life and financial situation. Research on cancer and work is therefore of great importance but scattered over Europe and lacking appropriate dissemination. Moreover, interventions supporting employment of cancer survivors are urgently required but scarcely developed. Methods The European Cancer and Work Network (CANWON) aims to combine knowledge on: (1) prognostic factors of unemployment in cancer survivors including gender- and country-specific differences; (2) work-related costs of survivorship for both patients and society; (3) the role of employers; and (4) development and evaluation of innovative, interdisciplinary interventions which effectively support employment. Furthermore, it aims at disseminating research knowledge and best practice worldwide. Results CANWON currently unites 23 teams from 15 countries across different stakeholders and research areas. The expected benefits are rapid exchange of research knowledge, standardised methods and techniques, innovative interventions, future guidelines on cancer and work and the improvement of quality of life of cancer patients. Conclusions Understanding prognostic factors, work-related costs, role of the employer and innovative interventions in relation to work in cancer survivors might progress the understanding of other patients with long-term conditions therefore the knowledge resulting from CANWON will benefit a wide range of patient groups.     

Quality of Care for Chronic Diseases in a British Cohort of Long-Term Cancer Survivors

PURPOSE Previous research has shown that long-term cancer survivors with other chronic diseases may receive poorer care for those diseases compared with the general population. We sought to establish the quality of care for chronic diseases among cancer survivors in the United Kingdom.METHODS From the UK General Practice Research Database, we identified 21,366 adult patients who had survived 5 or more years after a diagnosis of breast, colorectal, or prostate cancer with a diagnosis of hypertension, coronary artery disease, diabetes, or cerebrovascular disease. For each patient, an age-sex matched noncancer control patient was selected from the same general practice and with the same chronic disease. We compared the chronic disease care in cancer survivors and their matched controls.RESULTS The proportion of patients meeting quality standards for chronic disease care was high in both cancer survivors and control patients. Although cancer survivors were slightly less likely to receive blood pressure monitoring and cholesterol tests, this difference was no longer apparent if patients who died during the study period were excluded. For instance, 93% of breast cancer survivors received blood pressure monitoring compared with 94% of matched control patients. Similarly, control of disease was comparable among all patients, with the exception of diabetic prostate cancer survivors, who had fewer cholesterol readings under the control limit (17% reduction, 95% CI, 7%–26%) and diabetic colorectal survivors, who had fewer calendar quarters of glycated hemoglobin control (12% reduction, 95% CI, 2%–23%).CONCLUSIONS Care of comorbidities is not neglected in the United Kingdom because people have had a previous diagnosis of cancer. One explanation is that in the United Kingdom, such care is provided through a robust primary care system.     

Heroína,pero no Superwoman. Evaluación de una formación entre iguales para mujeres con cáncer de mama

ObjectiveTo evaluate a peer-training intervention for women with breast cancer, from a gender perspective: to discover the results of the intervention and examine in-depth the personal experiences of patients and health professionals participating in the training activity.MethodMixed method multicentre design completed in 2017 in Andalusia (Spain), with a pre and post evaluation questionnaire with 102 patients, measuring life style, limitations, use of health services, communication with professionals and self-management; and content analysis of semi-structured interviews and focus groups with 21 patient-trainers and 5 health professionals, looking at experiences, needs and suggestions for improvement.ResultsThe patients described a good general health status, with improvements of: diet quality (7 in pre-test to 7.7 in post-test), limitations for daily life (from 1.93 to 1.64 points), self-efficacy (from 6.46 to 7.42 points). Age, civil status and level of education generated statistically significant differences, with more improvement in more vulnerable social profiles. Participants revealed the benefits of the peer-training at a personal, relational, psycho-emotional and socio-cultural level and expressed how the training changed their experiences around identity-construction and gender roles. The improvement dimensions related to organization, evaluation and continuity.ConclusionsThe peer-training intervention is a positive experience for women's physical, relational and emotional health and, from a gender perspective, it represents an opportunity, at both individual and group level, to negotiate and deconstruct gender roles when living with breast cancer.     

Factors affecting health-related quality of life in women with recurrent breast cancer in Korea

PURPOSE: The purpose was to determine the effects of recurrent breast cancer on health-related quality of life (HRQOL). METHODS: We administered the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-BR23, McGill Quality of Life Questionnaire (MQOL), Beck Depression Inventory (BDI), and Brief Fatigue Inventory (BFI) to 152 women experiencing recurrence 1 year after being diagnosed with stage I to III breast cancer. We classified recurrent women as post-, ongoing-, and non-treatment group and performed multivariate-adjusted analyses in HRQOL comparisons with data available from disease-free survivors and general population. RESULTS: Groups not completing treatment were more symptomatic and had poorer functioning in HRQOL than the post-treatment group. Compared to the general population, the post-treatment group showed worse scores concerning role, cognitive, and social functioning, fatigue, and financial difficulties. The post-treatment group showed identical scores to disease-free survivors in most HRQOL domains; however, they reported less fatigue and depression than the disease-free group. Higher overall QOL was related to absence of comorbidity, completing treatment, being involved in decision making, no problems before surgery, and good overall medical care. CONCLUSION: Treatment completed, most degraded aspects of HRQOL in recurrent breast cancer women can return to levels observed in disease-free survivors.     

Employment and insurance outcomes and factors associated with employment among long-term thyroid cancer survivors: a population-based study from the PROFILES registry

Purpose

To obtain insight into employment and insurance outcomes of thyroid cancer survivors and to examine the association between not having employment and other factors including quality of life.

Methods

In this cross-sectional population-based study, long-term thyroid cancer survivors from the Netherlands participated. Clinical data were collected from the cancer registry. Information on employment, insurance, socio-demographic characteristics, long-term side effects, and quality of life was collected with questionnaires.

Results

Of the 223 cancer survivors (response rate 87 %), 71 % were employed. Of the cancer survivors who tried to obtain insurance, 6 % reported problems with obtaining health care insurance, 62 % with life insurance, and 16 % with a mortgage. In a multivariate logistic regression analysis, higher age (OR 1.07, CI 1.02–1.11), higher level of fatigue (OR 1.07, CI 1.01–1.14), and lower educational level (OR 3.22, CI 1.46–7.09) were associated with not having employment. Employment was associated with higher quality of life.

Conclusions

Many thyroid cancer survivors face problems when obtaining a life insurance, and older, fatigued, and lower educated thyroid cancer survivors may be at risk for not having employment.

     

Adherence to Guidelines for Cancer Survivors and Health-Related Quality of Life among Korean Breast Cancer Survivors

There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life (HRQoL). In a cross-sectional study of Korean breast cancer survivors, we examined whether adherence to the guidelines of the American Cancer Society (ACS) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) for cancer survivors was related to levels of HRQoL, assessed by the Korean version of Core 30 (C30) and Breast cancer module 23 (BR23) of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ). We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer (AJCC) stages I to III and had breast cancer surgery at least six months before the interview. Increasing adherence to ACS guidelines was associated with higher scores of social functioning (p for trend = 0.05), whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms (p for trend = 0.01). These associations were limited to those with stage II or III cancer. Diet may be an important factor in relation to quality of life among Korean breast cancer survivors, however our findings warrant further prospective studies to evaluate whether healthy diet improves survivors’ quality of life.     

Role retention and quality of life of bone marrow transplant survivors

Bone marrow transplantation (BMT) offers the potential for survival of 50% or more for selected patients with malignant disease not controlled by other means. However, BMT introduces risks for psychological, social, and physical impairment and the potential for significant loss in one's ability to retain important role relationships. While there has been a sharp increase in the performance of BMTs in the past decade, there has been little research on its effects on long-term survivors. This paper presents the results of a follow-up survey of 135 survivors of BMT at the Johns Hopkins Oncology center. The ability of the survivors to maintain valued social roles is examined as this affects perceived quality of life. The main hypothesis of the paper, that role retention is significantly related to higher quality of life, is supported by significant correlations of role retention with quality of life as measured by the Satisfaction with Life Domains Scale, current and future life satisfaction on Cantril Self-Anchoring Ladders, and by the Bradburn Positive Affect Scale. While the Bradburn Negative Affect Scale was not significantly related to role retention, total negative mood as measured by the Profile of Mood States was inversely related to role retention at a statistically significant level.     

Health-related quality of life among disease-free stomach cancer survivors in Korea

Previous studies about the quality of life (QOL) in stomach cancer survivors focused on selected clinical parameters and did not consider the broader implications for overall health and QOL. We evaluated the impact of demographic and treatment-related factors on the QOL of stomach cancer survivors. We asked 391 stage I–III stomach cancer survivors who had been disease-free for at least 1 year after surgery to complete a demographic questionnaire, the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire, and its stomach module, QLQ-STO22. Survivors undergoing total gastrectomy reported greater eating restrictions than those undergoing subtotal gastrectomy. Receiving chemotherapy or radiotherapy did not significantly affect any QLQ-C30 or QLQ-STO22 scores. Role and emotional functioning improved with increasing age, and stomach-specific symptoms (pain, eating restrictions, and anxiety) lessened. Compared with female survivors, male survivors had better physical and role functioning. Smoking status was also a significant negative predictor of physical functioning and anxiety. Comorbidities and selected demographic characteristics had a greater effect than type of treatment on the QOL of post-operative stomach cancer patients. Notes: Drs Jae-Moon Bae and Sung Kim contributed equally to this work as first authors. An erratum to this article can be found at     

年轻乳腺癌幸存者未满足需求的现状及影响因素分析

目的以年轻乳腺癌幸存者作为对象,针对其需求未满足进行研究,分析未满足主要因素,完善临床管理方案。方法选择郑州市4所三级甲等医院乳腺科门诊2021年5月至8月就诊的200例年轻乳腺癌幸存者,通过一般资料调查表、乳腺癌幸存者未被满足需求量表、社会支持评定量表、焦虑与抑郁量表进行调查,了解患者未满足需求现况,比较不同情况的患者未满足需求情况,分析影响因素。结果200例患者未被满足需求评价总分为(284.34±26.66)分,得分率为79.26%。单因素分析显示,患者是否已婚、文化情况、家庭收入、医疗保险、手术方式、疾病临床分期方面比较,差异均有统计学意义(P<0.05);Pearson相关性检验结果显示,患者未满足需求与社会支持呈负相关,与焦虑、抑郁呈正相关(P<0.05);多元线性回归结果显示,文化水平、婚否、家庭收入、医疗保险形式、手术方式、疾病临床分期、焦虑是患者未满足需求的影响因素(P<0.05)。结论年轻乳腺癌幸存者未满足需求较高,且受文化水平、收入水平、婚否、医疗保险形式、手术方式、疾病临床分期、焦虑等多种因素影响。医护管理中,应结合上述因素,设计科学护理方案,减轻患者的未满足需求。     

奥施康定治疗中晚期胃癌疼痛效果的临床观察

目的：评估奥施康定（OxyContin）用于胃癌中晚期患者的镇痛效果,同时观察奥施康定对于胃癌患者生活质量的影响。方法：选择68例胃癌中晚期患者给予奥施康定进行镇痛处理。初始剂量为10mg/12h。在治疗期间,用药剂量根据疼痛缓解程度进行调整,疗程持续15天以上。同时,对服药后的不良反应以及患者生活质量进行观察并记录。结果：奥施康定对中、重度胃癌疼痛的有效率分别为100%和92.0%,能够显著改善患者的睡眠质量和精神状态,同时不良反应较轻。结论：奥施康定能够有效控制中晚期胃癌疼痛,同时明显提高患者的生活质量。     

杭州市部分癌症患者的生存质量分析

根据生存质量所包含的躯体机能、精神状况、症状及治疗过程的副反应、社交状况四方面内容,参考有关文献设计调查表,对杭州市经省、市医院诊断的部分肺癌、胃癌、乳腺癌患者进行生存质量的调查。结果２３３名患者生存质量综合得分８１４１±９１７,处于中等水平。其中女性得分高于男性,＜６０岁者得分比≥６０岁者高,干部、教师、受教育程度高者、与子女同住、配偶身体健康、家庭每月人均收入高者得分较高;三种癌症中乳腺癌患者得分最高,手术治疗比其他疗法生存质量也较好。作为一种新的医学评价技术,生存质量此项指标在指导临床治疗上有一定作用。     

Quality of life and objective disease criteria in patients with intermittent claudication in general practice

BACKGROUND: The quality of life (QoL) of patients with chronic diseases is an important decision criterion for medical treatment, especially in primary care settings. It is known that subjective sickness feelings often cannot be correlated with objective disease criteria. OBJECTIVE: The aim of the study was to determine the QoL of patients with intermittent claudication with the arterial morphology, haemodynamic parameters and functional disability of peripheral arterial occlusive disease (PAOD). METHODS: In 150 patients with stable intermittent claudication, the health-related QoL was compared with the angiogram score, the resting Doppler pressure values, and the initial claudication distance (ICD) and absolute claudication distance (ACD) with treadmill exercise. RESULTS: The QoL did not correlate significantly with either the angiogram score or the ankle systolic blood pressure and ankle brachial index. ICD and ACD correlated significantly with the QoL activity subscales of pain, complaints and functional status (P < 0.001). In a multiple regression analysis, ACD and body mass index were the most predictive variables for the QoL. CONCLUSION: The QoL of PAOD patients is independent of the peripheral Doppler pressure and the angiographic severity of the disease. The most important criterion for the QoL is the patient's functional disability.     

Breast cancer survivors and vitamin D: A review

Recent evidence has suggested a role for vitamin D in breast cancer prevention and survival. Studies have reported an inverse relation between vitamin D intake and the risk of breast cancer, improvements in survival after a diagnosis of breast cancer in women with higher levels of vitamin D, and vitamin D insufficiency in up to 75% of women with breast cancer. Preclinical data have indicated that vitamin D affects up to 200 genes that influence cellular proliferation, apoptosis, angiogenesis, terminal differentiation of normal and cancer cells, and macrophage function. Vitamin D receptors have been found in up to 80% of breast cancers, and vitamin D receptor polymorphisms have been associated with differences in survival. Although ongoing studies have investigated a possible link between adequate levels of vitamin D and improved cancer prognosis, breast cancer survivors may derive additional, non–cancer-related benefits from adequate vitamin D levels, including improvements in bone mineral density, quality of life, and mood. Maintaining adequate vitamin D stores is recommended for breast cancer survivors throughout their lifetime.     

Anithistamine Therapy and Patient Perceptions

This study examines the perceptions of allergy patients with regard to the effects of antihistamine medication on their quality of life. Discriminant analysis is used to analyze the differences in patient perceptions based on whether th emedication is a non-sedating antihistamine versus a sedating antihistamine. The independent variables tested relate to the efficacy and side effects of the two types of therapy and some quality of life measures such as ability to perform daily activities, general health status, satisfaction with job performance and mood perceptions. Results indicate that patients on non-sedating antihistamines feel less drowsy, have more positive mood states, but perceive a higher level of other side-effects as compared to patients on sedating antihistamine therapy. The results have implications for drug advertisers and other marketing and health professionals.