Arab Cancer Patients Research Articles

Has the COVID-19 pandemic affected the psychological state of arab cancer patients?

The Covid-19 pandemic has increased the vulnerability of cancer patients to psychological symptoms, in addition to treatment modality issues. The present study has aimed to determine the psychological state of Arab cancer patients during the COVID-19 pandemic and to explore the contributing factors. A cross-sectional, descriptive, correlational design with the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Functional Assessment of Cancer Therapy–Fatigue subscale (FACT-F), and the Functional Assessment of Cancer Therapy–General (FACT-G) were used to collect the data. Out of 291 participants, 60.5% were female; 22.7% were 51–60 years; 31.6% were diagnosed with breast cancer; 44.3% with stage 2 cancer; 23% had contracted COVID-19; and 43.3% had received their first dose of the vaccine. The main study findings are: 74.9% had anxiety, 64.3% experienced depression, 68% suffered from insomnia, and 69.8% had fatigue. Quality of life (QoL) was low among cancer patients who had marked anxiety, depression, insomnia, or fatigue, and these findings were statistically significant (p < 0.05). Predictive factors showed males were 5.09 times more likely to report depression; gynecological cancer patients were 40.4 times more likely to experience insomnia, and patients who had COVID-19 were 5.13 times more likely to report fatigue. The study findings reveal that the COVID-19 pandemic affected the psychological state of cancer patients and had a significant effect on their quality of life. Hence, there is a need to develop a holistic cancer health care approach, which is often limited in Arab countries, to help patients manage these symptoms effectively and to decrease the prevalence of mental health morbidity.

Translation and Validation of the Arabic Version of the Cancer Needs Questionnaire-Short Form

Objective:Care needs among Arabic cancer patients have not been assessed previously due to the lack of translated instrument that can determine the care needs among the cancer patients in Arab countries. The aim of this study was to translate and validate an Arabic version of the Cancer Needs Questionnaire-Short Form (CNQ-SF).Methods:A cross-cultural adaptation and psychometric testing was used. Brislin's model of translation was used to translate the CNQ-SF from English to Arabic. A cross-cultural adaptation and psychometric testing was used. A sample of 113 participants with different types of cancer completed the study surveys including the CNQ-SF (Arabic version) and Functional Assessment of Cancer Therapy-General (FACT-G). Descriptive, bivariate statistics and exploratory factor analysis (EFA) were performed.Results:Content validity was evaluated by a panel of experts and 20 participants and showed that translated scale was clear, understandable, and logical in order. Reliability analysis of CNQ-SF domains ranged from 0.85 to 0.93 and 0.94 for the total Arabic version of CNQ-SF. Convergent analysis showed a significant relationship between CNQ-SF (Arabic version) and FACT-G. Results of EFA indicated that the CNQ-SF scale has 32-items. It consists of five domains, the results indicated that Kaiser–Meyer–Olkin was 0.851, and Bartlett's Test of Sphericity was significant (significant (P < 0.001).Conclusions:The current study indicates that the Arabic version of CNQ-SF is valid, reliable, and applicable. It can be used by researchers, clinical practitioners, and health educators in Arab countries.

Fatigue and Sleep Disturbance in Arabic Cancer Patients After Completion of Therapy: Prevalence, Correlates, and Association With Quality of Life.

Fatigue and sleep disturbance are 2 of the most common and distressing cancer symptoms that negatively affect quality of life. The aim of this study was to assess the prevalence of, and factors contributing to, fatigue and sleep disturbance in Arabic-speaking cancer patients in Oman after completion of their cancer treatment. A cross-sectional and descriptive correlational design was used. Data were collected using the Pittsburgh Sleep Quality Index where a score of >5 indicated as poorer sleep, the Functional Assessment of Cancer Therapy-Fatigue a score of ≤34 indicating clinically significant fatigue, and the Functional Assessment of Cancer Therapy-General. Of the 369 patients who participated, 77.5% (n = 286) reported clinically significant fatigue, and 78% (n = 288) reported poor sleep. Fatigue (P < .05) was significantly associated with age, cancer site, months since diagnosis, type of treatment received, and comorbidity. Those experiencing fatigue and poor sleep had the lowest quality of life among the cancer patients studied. Fatigue and sleep disturbance are significant problems for the Arabic patients diagnosed with cancer. Both fatigue and sleep disturbance should be routinely assessed in the case of such patients. Routine assessments of fatigue and sleep disturbance are recommended so that appropriate interventions and treatment management plans can be introduced to reduce fatigue and improve sleep quality among patients with cancer.

Validation of the Pittsburgh Sleep Quality Index (PSQI) with Arabic cancer patients

The Pittsburgh Sleep Quality Index (PSQI), a self-administrated questionnaire, is a frequently used instrument to assess sleep quality in clinical and non-clinical populations. The aim of the study was to evaluate the psychometric properties of the Arabic PSQI among patients diagnosed with cancer. A cross-sectional and descriptive correlational design was used with 369 patients with cancer completing the 19-item Arabic version of the PSQI. The scale was assessed in terms of acceptability, internal consistency and validity. The Cronbach’s alpha coefficient for the Arabic PSQI was 0.77, demonstrating acceptable reliability. The global PSQI score did not have floor or ceiling effects. The PSQI Arabic version demonstrated good discriminative validity. Construct validity was explored by confirmatory factor analysis to examine the dimensional structure of the PSQI. The confirmatory factor analysis showed an acceptable fit for refined one-factor model. The results support the original single factor structure of the PSQI. The Arabic version of the PSQI demonstrated adequate reliability and validity for assessing sleep quality in Arabic-speaking patients diagnosed with cancer.

Validation study of the Arabic version of the Brief Fatigue Inventory (BFI-A).

Fatigue is the most reported and most distressing symptom among patients with cancer. However, no questionnaire that measures fatigue and fatigue interference with life has been translated into Arabic. This study aimed to translate and validate the Arabic version of the Brief Fatigue Inventory (BFI-A). The BFI was translated into Arabic using the forward-backward translation technique. This cross-sectional study collected data from cancer patients through a self-administered questionnaire that included the BFI-A, Insomnia Severity Index (ISI), Zung Depression Scale (ZDS), MD Anderson Symptom Inventory total score (MDASI), and Medical Outcome Study Short Form 36 (SF-36) Vitality Subscale. Descriptive and inferential statistics were used including mean, standard deviation, internal consistency, and correlation coefficient using Pearson's correlation. A total of 79 patients were recruited in Amman, Jordan, in 2015. Mean of the total BFI-A was 4.01 (2.4), showing that 83.5% had nonsevere fatigue. Cronbach's α coefficient of the BFI-A was 0.93. The correlations between total BFI-A scores and BFI-A items were significant (P < 0.05) and ranged from 0.75 to 0.86. BFI-A showed a significant correlation (P< 0.05) with the following tools: ISI = 0.70, ZDS = 0.69, MDASI = 0.75, and SF-36 Vitality Subscale = -0.57. This study suggests that the BFI-A is a reliable and valid tool to assess fatigue among Arab cancer patients.

Psychometric Properties of the Arabic Version of the Functional Assessment of Chronic Illnesses Therapy–Fatigue in Arabic Cancer Patients

BackgroundThe Functional Assessment of Chronic Illness Therapy (FACIT) is a measurement system that was developed to assess the health-related quality of life among patients with cancer and other chronic illnesses. The Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) is a 40-item questionnaire, and it is one of the most frequently used instruments to assess fatigue in cancer populations. The aim of this study was to evaluate the psychometric properties of the Arabic FACIT-F among patients diagnosed with cancer. MethodsFollowing a translated and cross-cultural evaluation procedure of the FACIT-F Arabic version, a cross-sectional and descriptive correlational design was conducted. A total of 369 patients with cancer completed the FACIT-F, which consists of the 27-item Functional Assessment of Cancer Therapy–General (FACT-G) and the 13-item Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F). The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored through confirmatory factor analysis. ResultsThe FACT-G had acceptable fit in the four-factor model, whereas the FACIT-Fatigue was found to be acceptable for the one-factor model in Arabic patients diagnosed with cancer. The Cronbach's alpha coefficient for the Arabic FACIT-Fatigue was 0.92, whereas the total score for FACT-G was 0.92, which showed good reliability. There was evidence that discriminated validity analysis was generally very good for the FACIT-Fatigue and FACT-G Arabic versions. ConclusionThe Arabic versions of the FACIT-Fatigue and FACT-G demonstrated good reliability and validity for assessing fatigue and quality of life in patients diagnosed with cancer.

Psychometric evaluation of the Arabic Version the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Chemotherapy-Induced Peripheral Neuropathy Questionnaire (EORTC QLQ-CIPN20)

To date, there is no specific, valid, and reliable scale in the Arabic language to measure CIPN. The purpose of this study was to translate and validate the Arabic version of the EORTC QLQ-CIPN20. A cross-cultural adaptation and psychometric testing were used. A Convenience sample of 100 Arabic cancer patients completed the study’s surveys. A content validity involving experts and ten patients indicated that the statements were clear and in logical and easy order. Reliability analysis that the QLQ-CIPN20 subscales were internally consistent (Cronbach’s Alpha of 0.84, 0.79, and 0.81, respectively), as was the total QOL-CIPN20 (0.83). The results showed that there was a strong relationship between total QLQ-CIPN20 and total FACT/GOG-Ntx (−0.88, p < 0.001). Moderate negative relationships between total QLQ-CIPN20 and QLQ-C30- Global health status and QLQ-C30-Functional (−0.62 and −0.65, p < 0.001) were found. A positive relationship was found between total QLQ-CIPN20 and QLQ-C30- Symptom (0.63, p < 0.001). Results of the EFA showed that the 20-item scale reflecting three subscales including sensory, motor, and autonomic symptom and functioning. The Arabic version of the EORTC QLQ-CIPN20 can be used in clinical, research, and education settings in Arab countries.

Efficacy and Safety of Aprepitant in Combination with Dexamethasone, Granisetron and Metoclopramide as a Prophylaxis of Chemotherapy-Induced Nausea and Vomiting in a Acute and Delayed Emesis in Arab Cancer Patient

Background: Chemotherapy Induced Nausea and Vomiting (CINV) is one of the greatest sources of distress for patients. Severe CINV may force interruption of chemotherapy, it is important to control CINV to achieve successful chemotherapy. Objective: This study to evaluate the efficacy and safety of aprepitant in a regimen containing aprepitant in combination with dexamethasone, granisetron and metoclopramide (APRDGM) versus a regimen dexamethasone, granisetron and metoclopramide (DGM) only, as a prophylaxis in (CINV) in highly emetogenic chemotherapy(HEC) in Arabic cancer patients. Setting: This study was conducted at King Abdul-Aziz Medical city (Eastern Region, AlHasa, Saudi Arabia). Methods: 309 patients all Arab population, treated with HEC, were enrolled in a retrospective, cohort study to investigate the efficacy and safety of (APR-DGM) compared to (DGM) regimen. Main outcome measure: The primary efficacy endpoint was the complete response (CR) for acute emesis and determines the adverse drug events. Secondary endpoint was the CR for delayed emesis. Results: The APR-DGM regimen showed a significantly improved control in the management of CINV in patients treated with HEC in acute emesis compared to the DGM regimen (P=0.0021). No significant difference was observed between the two regimens regards to delayed emesis (P=0.145). Both regimens were well tolerated, and the rates of adverse events were not significantly different between the regimens. Conclusion: The addition of aprepitant to the standard regimen of dexamethasone, granisetron and metoclopramide was found to be significantly better than dexamethasone, granisetron and metoclopramide alone, but only in the control of acute emesis, with no significant change in delayed emesis in Arab population.

Recurrent TP53 missense mutation in cancer patients of Arab descent

Hereditary cancer comprises more than 10% of all breast cancer cases. Identification of germinal mutations enables the initiation of a preventive program that can include early detection or preventive treatment and may also have a major impact on cancer therapy. Several recurrent mutations were identified in the BRCA1/2 genes in Jewish populations however, in other ethnic groups in Israel, no recurrent mutations were identified to date. Our group established panel sequencing in cancer patients to identify recurrent, founder, and new mutations in the heterogeneous and diverse populations in Israel, We evaluated five breast cancer patients of Arab descent diagnosed with cancer before the age of 50years and identified the previously described TP53 mutation, c.541C>T, R181C (rs587782596), in two women from unrelated Arab families. The two probands were diagnosed with breast cancer at a young age (27 and 34years) and had significant family history spanning a wide range of tumors (breast cancer (BC), papillary thyroid cancer, glioblastoma multiform (GBM), colon cancer and leukemia). The R181C variant is expected to disrupt p53 at the ASPP2 binding domain but not the DNA binding domain and is defined by Clinvar as likely pathogenic and in HGMD as disease mutation. We further tested 85 unrelated Arab cancer patients and father of a BC carrier patient for TP53 c.541C>T using a real time polymerase chain reaction (RT-PCR) approach and identified four additional carriers, two with BC one with lung cancer, and the father of a BC carrier patient, diagnosed with GBM. Another carrier suffering from BC was identified using a Myriad panel, suggesting a recurrent mutation in this population with a frequency of 5/42 (11.9%) of our selected BC patients. We suggest testing Arab women with a breast cancer at a young age, Arab patients with multiple malignancies, or with suggestive family history for TP53 c.541C>T.

One Hand Cannot Clap—A Study of Arab Practitioners of Traditional and Complementary Medicine in Israel: Identifying Barriers to Integrative Oncology Care

The integration of complementary medicine is gradually becoming an accepted part of standard care for patients with cancer. In our integrative oncology program, we have encountered difficulties in recruiting Arab patients. In order to understand the special needs of this population, we conducted interviews among Arab practitioners of complementary and traditional medicine (CTM). The characteristics of practitioners and their views regarding the therapeutic process were examined. Semi-structured qualitative interviews were administered to 27 Arab practitioners of CTM whose clientele was comprised primarily of Arab cancer patients. Conventional content analysis of the transcribed interviews and field notes was performed in order to identify key themes. Three groups of CTM practice were identified: Folk-herbal medicine (n = 9), complementary medicine (CM; n = 14), and religious healing (n = 4). Seven factors were identified in the practitioner accounts: the duration and scheduling of treatment sessions, the language of communication, the presence of family members, the appearance of the practitioner, the definition of treatment goals, the discussion of behavioral and lifestyle changes, and finally, the use of tangible elements in treatment. The study of Arab CTM practitioner recommendations may help facilitate a culture-sensitive encounter with Arab patients with cancer. This approach may also have implications for other ethno-culturally unique populations.

Diffusion of technical change in medicine— a case study of oncology in a traditional society

This article reviews a new program established to provide modern modes of oncologic therapy to Arab cancer patients in the West Bank. The population of this region is distinguished by its fatalistic and traditional attitudes, and communication via word of mouth is prevalent. Therefore, the social system can be considered as one of traditional norms discouraging the adoption of new ideas. Demonstration effects and face-to-face communication proved effective in bringing about social change in health patterns.