Cancer-related Quality Of Life Research Articles

The relationship between patient-reported and objective measures of physical function among cancer survivors receiving rehabilitation care: A correlation analysis.

Physical function is associated with cancer-related quality of life and survival. The correlation of patient-reported and objective measures of physical function has not been quantified previously in the cancer rehabilitation medicine setting. To correlate patient-reported physical function with objective measures of physical function. The secondary aim is to correlate fatigue and social participation levels with objective measures of physical function. Retrospective. Tertiary university cancer center. A total of 226 cancer survivors referred to an outpatient cancer rehabilitation medicine clinic. Not applicable. Correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) Cancer Function Brief 3D Profile domains with objective physical function measured by the 30-second sit-to-stand and hand grip strength. Pearson correlation analysis revealed a moderate correlation between patient-reported physical function and the 30-second sit-to-stand test (r = 0.57; p <.001), and a weak correlation of patient-reported physical function and handgrip strength (r = 0.27; p <.001). Multivariable regression modeling controlling for age, gender, and receipt of systemic therapy demonstrated a significant association between patient-reported physical function and the 30-second sit-to-stand test (estimated confidence interval 0.76 [0.60, 0.92], p < .01), in addition to patient-reported function and handgrip strength (estimated 0.22 [0.10, 0.34], p < .01). Multiple myeloma but no other cancer type was inversely associated with lower physical function. Patient-reported physical function correlated moderately with the 30-second sit-to-stand test, whereas hand grip strength demonstrated a weak correlation. The 30-second sit-to-stand test is a suitable substitute for patient-reported physical function. Further work evaluating how measures relate to each other across cancer populations is needed before recommending a standardized set of outcome measures.

Exploring patient reported quality of life in lung cancer patients: A qualitative study of patient-reported outcome measures.

Lung cancer is the leading cause of cancer-related death globally and provides a major disease burden likely to substantially impact quality of life (QoL). Patient-reported outcome measures (PROMs) have been identified as effective methods of evaluating patient QoL. Existing lung cancer-specific PROMs however have uncertain utility and minimal patient involvement in their design and development. This qualitative study aimed to evaluate the patient perspective of existing PROMs and to explore their appropriateness for population-based descriptions of lung cancer-related QoL. A descriptive qualitative study was conducted consisting of semi-structured interviews with 14 patients recruited from the Victorian Lung Cancer Registry and Alfred Hospital using purposive sampling. Interviews first explored the factors most important to lung cancer patients QoL, and second, patient's perspectives on the appropriateness of existing PROMs. Thematic analysis was used to develop themes, and content analysis was conducted to determine PROM acceptability. Five novel themes were identified by patients as being important impacts on QoL: Personal attitude toward the disease is important for coping; independence is valued; relationships with family and friends are important; relationships with treating team are meaningful; personal and public awareness of lung cancer is limited. These patient-identified impacts are poorly covered in existing lung cancer-specific PROMs. Patients welcomed and appreciated the opportunity to complete PROMs; however, they identified problems with existing PROMs relevance, tone, and formatting. Existing lung cancer PROMs poorly reflect the five themes identified in this study as most important to lung cancer patients QoL. This study reaffirms the need to review existing PROMs to ensure utility and construct validity. Future PROM development must engage key patient-generated themes and evolve to reflect the changing management and therapeutic landscape.

Cost-effectiveness of the ONCORAL multidisciplinary programme for the management of outpatients taking oral anticancer agents at risk of drug-related event: protocol for a pragmatic randomised controlled study

IntroductionThe development of oral anticancer agents (OAA) has profoundly changed cancer care, leading patients to manage their chemotherapy treatment on an outpatient basis. The prevention of iatrogenic effects of OAA...

Perceived Injustice in Cancer Survivors: Population-Specific Cut-Off Score and Relations with Personal Factors, Symptoms and Quality of Life-A Cross-Sectional Study.

Fatigue and pain are the most common side effects impacting quality of life (QoL) in cancer survivors. Recent insights have shown that perceived injustice (PI) can play a substantial role in these side effects, but research on cancer survivors is scarce. Furthermore, guidelines for recognizing clinically relevant levels of PI in cancer survivors are missing. The aims of this study are to provide a clinically relevant cut-off for PI and to explore relationships between personal characteristics, symptoms, and QoL with PI. This multicenter, cross-sectional study uses the Injustice Experience Questionnaire (IEQ), Numeric Pain Rating Scale (NPRS), Patient-Specific Complaints (PSC), Multidimensional Fatigue Index (MFI), and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (EORTC-QLQ-C30). A clinical cut-off for PI was identified based on the 75th percentile of IEQ scores. Univariate and multivariate regressions explored the relationship between PI and personal characteristics (sex, age, cancer type, treatment type), symptoms (pain intensity, fatigue), and QoL (daily activity complaints, cancer-related QoL). Cancer survivors (n = 121) were included, and a cut-off of 20 was identified. Significant indirect associations were found between chemotherapy, NPRS, PSC, MFI, and EORTC-QLQ-C30 with PI. In the multivariate model, only MFI (B = 0.205; 95% CI: 0.125-0.018) and age (B = 0.086; 95% CI: -0.191-0.285) maintained a significant association with PI.

Feasibility of Weekly Electronic Patient- and Proxy-Reported Outcome Measures in Pediatric Oncology.

Electronic patient-reported outcome measures (ePROMs) benefit adult cancer care, but their use in pediatric cancer care is limited. To explore the feasibility of collecting weekly ePROMs from pediatric cancer patients and/or their caregivers and to describe children's levels of symptom burden, distress, and cancer-related quality of life. A prospective and longitudinal cohort study was undertaken at one tertiary children's cancer center. Children (2-18 years)/caregivers completed ePROMs with validated measures for distress, symptom burden, and cancer-related quality of life weekly for 8 weeks. Seventy children/caregivers participated in the study, and 69% completed ePROMs at all 8 weeks. Distress and cancer-related quality of life significantly improved over time. However, at week 8, almost half of the participants still reported high levels of distress. Symptom burden decreased over time, with the youngest and the oldest age groups (2-3 and 13-18 years) reporting the highest number of symptoms with severe burden. Weekly collection of ePROMs in pediatric cancer care is feasible. Although distress, quality of life, and symptom burden improve over time, there is a need for timely assessment and interventions to improve symptoms, high levels of distress, and issues that negatively affect quality of life. Nurses are ideally placed to intervene, assess, and monitor symptoms and to provide symptom management advice to pediatric cancer patients and caregivers. Findings from this study may inform the design of models of pediatric cancer care to improve communication with the healthcare team and patient experience of care.

Nurse-Supervised Exercise for People with Stage IV Cancer: The EFICANCER Randomized Clinical Trial

ObjectivesTo assess the effectiveness of the EFICANCER individualized and supervised exercise program for people with gastrointestinal, breast, or non−small cell lung stage IV cancer, in terms of quality of life and functional capacity. Data sourcesRandomized controlled clinical trial with two parallel groups: EFICANCER (n = 47) and control (n = 43). Both groups received standard oncological care. In addition, the EFICANCER group participated in a nurse-supervised exercise program. Primary outcome was cancer-specific (EORTC QLQ-C30 questionnaire) and general quality of life (SF-36) at baseline and after 2, 6, and 12 months. Secondary outcomes were functional capacity (6-minute walking test), strength, and fatigue. The evolution in both groups was compared over 12 months using mixed-effect longitudinal models; 74.47% of patients completed at least one session of the program. At 12 months, EFICANCER group had better scores in cancer-related quality of life, with a difference between groups of 15.7 points (95% confidence interval 4.4 to 25.9) and in functional capacity, with a difference of 4.5 points (95% confidence interval −0.5 to 9.5). No significant differences in any other secondary variables were observed. ConclusionThe EFICANCER primary care nurse supervised exercise program is safe and feasible and improves cancer patient's outcomes. Implications for Nursing PracticeProviding the best care and trying to improve the quality of life of cancer patients are essential parts of nursing practice. Eficancer adds a new dimension to nursing practice by providing greater attention and care to patients during treatment through the supervision of physical exercise, thereby contributing to improve the quality of life of this population.

Effect of transcutaneous auricular vagal nerve stimulation on the fatigue syndrome in patients with gastrointestinal cancers — FATIVA: a randomized, placebo-controlled pilot study protocol

BackgroundCancer-related fatigue (CRF) is defined as a “distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.” CRF is frequently observed in cancer patients even before the initiation of tumor therapy. Its cause is not clear, but in addition to primary effects of therapy, a tumor-induced elevated level of inflammatory cytokines may play a role. Transcutaneous auricular vagal nerve stimulation (taVNS) is a noninvasive way to activate central nervous pathways and modulate pain perception and the immune system. It has positive effects on autoimmune conditions and can also improve fatigue associated with Sjogren’s syndrome. It is the main purpose of this feasibility study to investigate the feasibility of daily taVNS against CRF. Therefore, the stimulation protocol of the newly introduced smartphone app of the manufacturer is evaluated. Additionally, the effect taVNS on CRF and quality of life (QoL) shall be evaluated.MethodsThirty adult patients with gastrointestinal tumors during or after treatment, relevant CRF (Hornheide questionnaire) and life expectancy > 1 year, are enrolled. Patients are randomized to treatment or sham arm and be informed that they will either feel the stimulation or not. Treatment group will receive left-sided tragus above-threshold stimulation with 25 Hz, 250 µs pulse width, and 28-s/32-s on/off paradigm for 4 h throughout the day for 4 weeks. Sham group will receive no stimulation via a nonfunctional electrode. A daily stimulation protocol with time and average intensity is automatically created by a smartphone app connected to the stimulator via Bluetooth®. Multidimensional Fatigue Inventory-20, Short-Form 36 and Beck Depression Inventory questionnaires will be filled out before and after 4 weeks of stimulation.DiscussionPrimarily, the patients’ daily stimulation time and intensity will be evaluated through the electronic protocol after 4 weeks. Secondarily, the effect of taVNS on cancer-related fatigue and QoL will be measured through the questionnaires. As taVNS seems to modulate inflammatory cytokines, this noninvasive method may — if accepted by the patients — be a promising adjunct in the treatment of cancer-related fatigue.Trial registrationThe study was approved by local ethics committee (21–7395) and registered at the DRKS database (DRKS00027481).

Associations between Adult Primary Brain Tumor Survivors’ Behavioral Executive Functions, Health Related Quality of Life and their Caregivers’ Health Related Quality : A cross-sectional study

ABSTRACT The present study focused on adult primary brain tumor (PBT) survivors’ caregivers. The main objective was to study associations between PBT survivors’ health-related quality of life (HRQOL), their behavioral executive functions (EF) and their caregivers’ HRQOL. Forty PBT survivors of PBT and 37 caregivers (mostly patient’s spouses 81.08%; n = 30) participated in the study. PBT survivors completed a cancer related Quality of Life (QOL) questionnaire. Caregivers completed informant rated HRQOL and behavioral EF reports relating to PBT survivors and a self-rated HRQOL questionnaire relating to themselves. Correlational and multiple regression analyses were conducted. No associations were found between caregivers’ physical HRQOL and PBT survivors’ HRQOL nor behavioral EF. Analyses yielded several significant correlations between caregivers’ mental HRQOL and variables pertaining to PBT survivors’ HRQOL and behavioral EF. Multiple regression analyses showed that caregivers’ mental HRQOL is predicted by PBT survivors’ mental HRQOL, global cancer-related QOL scores and global behavioral EF scores. This study provides evidence suggesting that during the survivorship phase, at an average of 3.67 (SD = 2.31) years following treatment for a PBT, caregivers mental HRQOL is linked to PBT survivors’ long-term effects. These findings shed some light regarding post-cancer care for both PBT survivors and their caregivers.

Correlation between fatigue and quality of life in patients pediatric oncology

Estimates of pediatric cancer by 2022 are 8,500 / year of new cases, which then leads to being considered a public health problem. In addition, cancer treatment can lead to various problems, including fatigue, impacting the quality of life of these patients. Thus, this study aims to correlate fatigue and quality of life in pediatric cancer patients undergoing treatment. A cross-sectional study was carried out, in which 30 patients participated, divided into “outpatient group” and “inpacient group”, according to the place where the data collection was performed. Demographic and clinical data were obtained and two questionnaires were then applied: fatigue (PedsQL ™ Multidimensional Fatigue Scale) and cancer-related quality of life (PedsQL ™ Pediatric Quality of Life ™ Cancer Module). Most of the participants were male and with a mean age of 14 ± 2.89, among the types of cancer presented, leukemia was the most prevalent (43.33%). The inpacient group had more fatigue and less quality of life. life when compared to outpatient, Still, when correlating in general, fatigue has a negative impact on the quality of life of pediatric cancer patients. Therefore, the values presented in this study, point out that fatigue and quality of life are closely linked and that studies are needed in order to develop rehabilitation protocols and, mainly, to create better health conditions and encourage the oncological patient to become functional and independent. with better chances of survival.

Persistent Postsurgical Pain in Oral Cancer Patients Reconstructed with Anterolateral Thigh Free Flap.

Background and Objectives: The anterolateral thigh (ALT) flap is widely used in head and neck reconstruction, but the postoperative thigh sensory function lacks sufficient evaluation. The present study reports the postsurgical pain and cancer-related quality of life (QoL) in different stages of oral cancer patients receiving anterolateral thigh (ALT) flap reconstruction. Materials and Methods: Patients were subgrouped into postoperative early-, mid-, and late-recovery stages (postoperative 0.5–1 years, 1–2 years, and above 2 years) according to the time point of assessment. The QoL was examined using the EORTC C-30. Postsurgical donor and receipt site pain was evaluated through subjective reports and sensory tests. Results: Ninety-four patients were included in the final analysis. The functional and global health-related QoL significantly improved with time after surgery. However, spontaneous pain was reported in 57.7%, 72.3%, and 42% of patients in early-, mid-, and late-recovery stages, mainly in donor sites rather than in receipt sites. The highest incidence of donor site pain after ALT flap reconstruction in oral cancer surgery was in the mid-recovery stage but remained high in the late-recovery stage (56.8% and 36.7%, respectively). Conclusions: The postsurgical pain in the donor site might persist to or exhibit delayed onset one to two years postoperatively but is much improved after postoperatively two years later. A longer postsurgical follow-up for over two years for pain and sensory dysfunction is indicated.

Abstract P4-11-25: Burden of financial toxicity in an underserved population of breast cancer survivors

Abstract Background: The impact of financial toxicity (FT) on cancer patients is significant in terms of lost productivity and poor quality of life (QoL). Past studies have reported negative influence of high FT on patients actively undergoing treatment for breast cancer. However, existing data largely comes from quaternary referral centers, and the populations surveyed may not be generalizable in terms of income and insurance status across the United States. There is also limited understanding regarding the relationship between FT measured throughout the continuum of cancer care, demographics, disease factors, and QoL indicators in breast cancer survivors, particularly those from underserved communities. Methods: Breast cancer survivors who received treatment between 2015 and 2019 at Loma Linda University Cancer Center located in San Bernardino County, CA were invited to complete an anonymous online survey assessing demographics, disease history, FT, and QoL. A modified version of the Comprehensive Score for Financial Toxicity (COST) survey was used to assess FT at baseline and after treatment. The patient-reported outcomes measurement information system (PROMIS) survey was used to assess QoL. Demographic data were summarized using descriptive statistics. Associations between disease factors and FT measured at baseline and after treatment were analyzed using multivariable linear regression. Positive COST score coefficients indicate lower FT, while negative COST score coefficients indicate higher FT. Correlations between FT and QoL were evaluated using the Pearson correlation. Results: A total of 407 surveys were sent to breast cancer survivors who met study criteria, of whom 16% responded. Amongst 65 patients included in this analysis, the median age was 64 (IQR 56, 70), 68% were white (n = 44), 18% were unemployed, 13% had a high school or lower level of education, and 16% had an annual income &amp;lt; $30,000. Mean COST score at baseline and after treatment were 21.6 ± 9.6 and 12.9 ± 7.8, respectively. During treatment, 21% of patients turned down or skipped treatment, 23% quit their job, and 15% reported family members quit their job. At baseline, lower FT was significantly associated with age &amp;gt; 80 (6.2 95% CI: 4.1 to 8.3), presence of a college (4.5 95% CI: 1.4 to 10.4) or graduate degree (5.2 95% CI: 4.7 to 6.2), current employment (2.7 95% CI: 2.0 to 3.4), retiree status (6.7 95% CI: 0.4 to 13.0), and household income &amp;gt; $30,000 (5.9 95% CI: 2.7 to 9.1) (p &amp;lt; 0.05), while higher FT was significantly associated with Hispanic ethnicity (-4.1 95% CI: -6.7 to -1.5), Medicare (-1.6 95% CI: -5.2 to -2.0), and Medicaid insurance (-6.9 95% CI: -12.5 to -1.2) (p &amp;lt; 0.05). After treatment, higher FT was significantly associated with receiving 3 or more combined modality treatments (-5.6 95% CI: -9.7 to -1.5) and having 5 or more treatment-related side effects (-6.0 95% CI: -10.4 to -1.6) (p &amp;lt; 0.05). Finally, FT after treatment overall correlated positively with physical and mental health (Pearson coefficient 0.63 and 0.60 respectively, p &amp;lt; 0.01). Conclusions: These findings suggest a significant association between FT, baseline demographics, treatment modalities, side effects, and quality of life in an underserved population of breast cancer survivors. In the future, FT should be assessed at baseline and throughout the continuum of breast cancer care to provide individualized assistance to patients facing financial strain, as it affects compliance to treatment which in turn can adversely affect cancer-related outcomes and QoL. Additional policies are needed to address the increasing cost of breast cancer care. Citation Format: Akhil Mehta, Jukes Namm, Ellen D'Errico, Eric Lau, Sharon Lum, Gayathri Nagaraj. Burden of financial toxicity in an underserved population of breast cancer survivors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-25.

The impact of caregiver anxiety/depression symptoms and family functioning on child quality of life during pediatric cancer treatment: From diagnosis to 6 months

Objectives: A pediatric cancer diagnosis can have a significant impact on the quality of life (QOL) of the child. Diagnosis and treatment impact caregiver anxiety/depression symptoms and family functioning, and these in turn may influence child QOL. However, there has been limited longitudinal examination of the impact of both caregiver anxiety/depression symptoms and family functioning on youth QOL at specific points during the early diagnosis and treatment period. Methods: Ninety-six caregivers of youth (diagnosed with leukemia/lymphoma or a solid tumor) reported on their own anxiety/depression symptoms, family functioning, demographic and medical factors, and on their child’s generic and cancer-specific QOL shortly after diagnosis (T1) and 6 months later (T2). Results: Caregiver anxiety/depression symptoms were associated with poorer cancer-specific and generic child QOL within and across time points. Family conflict was associated with youth cancer-related QOL at T1. Conclusions: Attendance to caregiver anxiety/depression symptoms and family functioning, beginning early in the cancer trajectory, is an important aspect of family-centered care. Routine psychosocial screening and triage may help identify and intervene to support both caregiver and child psychosocial well-being.

Fear of Cancer Recurrence and Its Negative Impact on Health-Related Quality of Life in Long-term Breast Cancer Survivors.

PurposeFear of cancer recurrence (FCR) is a common psychological issue in breast cancer (BC) survivors during early survivorship but whether the same is true among long-term survivors has yet to be empirically evaluated. This study investigated FCR level, its associated factors, and impact on quality of life (QoL) in long-term BC survivors.Materials and MethodsParticipants included women diagnosed with BC between 2004 and 2010 at two tertiary hospitals. Survey was conducted in 2020. The study measured FCR with the Fear of Cancer Recurrence Inventory and other patient-reported outcomes, including depression and cancer-related QoL. Logistic regression was used to identify factors associated with FCR, and structural equation modeling was conducted to explore the impact of FCR on other outcomes.ResultsOf 333 participants, the mean age at diagnosis was 45.5, and 46% experienced FCR. Age at diagnosis ≤ 45 (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.51 to 4.60), shorter time since diagnosis (aOR, 1.75, 95% CI, 1.08 to 2.89), and having a history of recurrence (aOR, 2.56; 95% CI, 1.16 to 5.65) was associated with more FCR. FCR was significantly associated with an increased risk of depression (β=0.471, p < 0.001) and negatively impacted emotional functioning (β=−0.531, p < 0.001). In addition, a higher FCR level may impair overall health-related QoL in long-term BC survivors (β=−0.108, p=0.021).ConclusionTen years after diagnosis, long-term BC survivors still experienced a high level of FCR. Further, the negative impact of FCR on QoL and increased depression risk require an FCR screening and appropriate interventions to enhance long-term BC survivors’ QoL.

Social constraints and cancer-related quality of life in single and partnered young adult testicular cancer survivors: a contextual approach

Purpose/objective To examine the context of relationship status on the link between friends/family social constraints (SCff) and cancer-related quality-of-life (QOL) among young adult testicular cancer survivors. Design/research approach Participants completed the Functional Assessment of Cancer Therapy (general version), the Social Constraints Scale (friends/family), and demographic questions. Sample/participants The sample included 162 young adult testicular cancer survivors. Findings SCff, but not relationship status, significantly predicted QOL when controlling for age, time since diagnosis, education, and income. The SCff X relationship status interaction was significant such that SCff were more strongly related to lower QOL for single survivors than for partnered survivors. Implications Focusing on friends and family support of young adult survivors, findings highlight the vulnerability of single survivors to social constraints within their diffuse social network. Interventions that target supportive exchanges in friends and family networks may be useful in improving QOL in single young adult cancer survivors.

Unmet needs among Danish women with breast cancer in the transition from diagnosis into the early treatment phase

This study investigates the supportive needs of women diagnosed with breast cancer in the early treatment phase. The aim of this study was to identify unmet supportive care needs in the early treatment phase of women treated for breast cancer. This study employed a quantitative longitudinal design with baseline questionnaire (Time 1) and a six-month follow-up questionnaire (Time 2) that explored a variety of characteristics using both standardized scales and more explorative questions about employment situation, needs, rehabilitation, psychological, physical and social experiences. Eighty-five percent of the invited potential women agreed to participate, and 100 participants completed the baseline questionnaire. The analysis identified results concerning employment situation, depressive symptoms, unmet needs, distress, sexual life, social constraints and cancer-related quality of life. The study concludes that health professionals must embrace the challenges faced by the women and provide strategies to support women achieving meaningful lives.

Financial toxicity in gynecologic cancer survivors and its impact on quality of life.

53 Background: Financial toxicity (FT) is a critical concern for cancer survivors. There is limited data about the relationship between FT throughout the continuum of cancer care, demographics, disease factors, and quality of life (QoL) indicators in gynecologic cancer survivors. Methods: Gynecologic cancer survivors who received treatment from 2015 to 2019 at Loma Linda University Cancer Center were invited to complete an anonymous online survey. A modified version of the comprehensive score for financial toxicity (COST) survey was used to assess FT at baseline and after treatment. The patient-reported outcomes measurement information system (PROMIS) survey was used to assess QoL. Demographic data were summarized using descriptive statistics. Associations between disease factors and FT measured at baseline and after treatment were analyzed using univariable linear regression. Lower COST score coefficients indicate greater FT. Correlations between FT and QoL were evaluated using the Pearson correlation. Results: A total of 252 surveys were sent to gynecologic cancer survivors who met study criteria, of whom 28% responded. Amongst 70 patients included in this analysis, the median age was 64 (IQR 56, 70), 47% were white (n = 33), 20% were unemployed, 22% had a high school or lower level of education, and 50% had an annual income &lt; $60,000. With respect to cancer subtype, 63% had uterine cancer (n = 44), 20% had cervical cancer (n = 14), and 17% had ovarian cancer (n = 12). The mean COST score at baseline and after treatment was 21.2 ± 9.2 and 12.9 ± 7.8, respectively. The following characteristics were associated with significantly greater FT at baseline: Hispanic ethnicity (-5.5; 95% CI: -1 to -10), Black race (-14.4; 95% CI: -3.4 to -25.4), household number &gt; 4 (-6.9; 95% CI: -2.6 to -16.4), Medicare insurance (-6.5; 95% CI: -1.7 to -11.2), and Medicaid insurance (-11.2; 95% CI: -4.3 to -17.9) (p &lt; 0.05). Patients who received combined modality surgery, chemotherapy, and radiation had significantly higher FT (-5.6; 95% CI: -1.3 to -9.8, p &lt; 0.05) compared to those who received single-modality treatment. Likewise, patients with 5 or more treatment-related side effects had significantly higher FT (-6.3; 95% CI -1.13 to -11.4, p &lt; 0.05) compared to those who reported no side effects. During treatment, 24% of patients turned down or skipped treatment, 38% quit their job, and 28% reported family members quit their job. Finally, COST scores measured after treatment correlated positively with physical and mental health (Pearson coefficient 0.57 and 0.56 respectively, p &lt; 0.001). Conclusions: These findings support the need for assessing FT at baseline and throughout the continuum of cancer care to provide individualized assistance to patients facing financial strain. FT affects compliance to treatment which can adversely affect cancer-related outcomes and QoL. Additional policies are needed to address the increasing cost of cancer care.

Irregular Sleep/Wake Patterns Are Associated With Reduced Quality of Life in Post-treatment Cancer Patients: A Study Across Three Cancer Cohorts.

Background: Cancer patients often describe poor sleep quality and sleep disruption as contributors to poor quality of life (QoL). In a cross-sectional study of post-treatment breast, endometrial, and melanoma cancer patients, we used actigraphy to quantify sleep regularity using the sleep regularity index (SRI), and examined relationships with reported sleep symptoms and QoL.Methods: Participants were recruited post-primary treatment (35 diagnosed with breast cancer, 24 endometrial cancer, and 29 melanoma) and wore an actigraphy device for up to 2 weeks and SRI was calculated. Self-report questionnaires for cancer-related QoL [European Organization for Research and Treatment of Cancer EORTC (QLQ-C30)] were completed. Data were compared using analysis of variance (ANOVA) or Chi-Square tests. Multivariate linear regression analysis was used to determine independent variable predictors for questionnaire-derived data.Results: Age distribution was similar between cohorts. Endometrial and breast cancer cohorts were predominantly female, as expected, and body mass index (BMI) was higher in the endometrial cancer cohort, followed by breast and melanoma. There were no differences between tumor groups in: total sleep time, sleep onset latency, bedtime, and SRI (breast 80.9 ± 8.0, endometrial 80.3 ± 12.2, and melanoma 81.4 ± 7.0) (all p > 0.05). A higher SRI was associated with both better functional and symptom scores, including increased global QoL, better physical functioning, less sleepiness and fatigue, better sleep quality, and associated with less nausea/vomiting, dyspnea, and diarrhea (all p < 0.05).Conclusion: In cancer patients post-treatment, greater sleep regularity is associated with increased global QoL, as well as better physical functioning and fewer cancer related symptoms. Improving sleep regularity may improve QoL for cancer patients.

MP43-19 SELF-REPORTED EMOTIONAL FUNCTIONING OF MEN UNDERGOING ACTIVE SURVEILLANCE, RADICAL PROSTATECTOMY, OR RADIOTHERAPY IN THE EUPROMS STUDY

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP43)1 Sep 2021MP43-19 SELF-REPORTED EMOTIONAL FUNCTIONING OF MEN UNDERGOING ACTIVE SURVEILLANCE, RADICAL PROSTATECTOMY, OR RADIOTHERAPY IN THE EUPROMS STUDY Lionne Venderbos, André Deschamps, Ernst-Günther Carl, John Dowling, Renée Hogenhout, Sebastiaan Remmers, and Monique Roobol Lionne VenderbosLionne Venderbos More articles by this author , André DeschampsAndré Deschamps More articles by this author , Ernst-Günther CarlErnst-Günther Carl More articles by this author , John DowlingJohn Dowling More articles by this author , Renée HogenhoutRenée Hogenhout More articles by this author , Sebastiaan RemmersSebastiaan Remmers More articles by this author , and Monique RoobolMonique Roobol More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002064.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Treatment for localized prostate cancer (PCa) is a preference-sensitive decision in which aspects such as post-treatment quality of life (QoL) should be taken into account. Europa Uomo, representing the voice of men with PCa in Europe, initiated the patient-driven Europa Uomo Patient Reported Outcome Study (EUPROMS) to inform their members about QoL post-PCa treatment. Here the self-reported data on emotional functioning are presented for men who underwent active surveillance (AS), radical prostatectomy (RP), or radiotherapy (RT). METHODS: An invitation to complete a cross-sectional online survey was distributed through Europa Uomo’s network to European PCa patients who underwent treatment. The survey included, amongst others, the EORTC-QLQ-C30 to measure cancer-related QoL [Venderbos et al., Eur Urol Focus 2020*]. The EORTC-QLQ-C30 emotional functioning scale scores and the items that comprise the scale are presented. Item proportions of the three treatment groups were compared with the proportion test. RESULTS: A total of 2943 men completed the EUPROMS survey; respondents median age is 71 years (IQR 65-75) and 82% was living with a spouse. A total of 179 (6.1%) men underwent AS, 1101 (37.4%) RP, and 304 (10.3%) RT. The median emotional functioning scale score is 91.7 for AS, RP and RT with some variation in the IQRs. Looking at the single items of the emotional functioning subscale, proportionally there were slightly more men on AS that felt tense ‘quite a bit’ (10.1% vs. 6.5% and 7.9%, χ(2)=3.4, p=0.2), were worried ‘quite a bit’ (15.6% vs. 10.9% and 9.2%, χ(2) = 4.9, p=0.087), felt irritable ‘quite a bit’ (12.3% vs. 7.5% and 6.3%, χ(2) = 6.1, p=0.047), and felt depressed ‘quite a bit’ (12.9% vs. 8.9% and 7.6 %, χ(2) = 4.0, p=0.14). CONCLUSIONS: Overall, data from the patient-initiated EUPROMS study show that in terms of emotional functioning, AS, RP and RT are well-tolerated treatments. On an individual level it will, however, be interesting to try to identify factors that are associated with positive and negative psychological responses to both diagnosis and treatment of localized PCa, to optimize psychological outcomes also for those men that felt ‘quite a bit’ more tense, worried, irritable or depressed. Source of Funding: This work was supported by Bayer, Ipsen and Janssen. The funders did not play any role in the study design, collection, analysis or interpretation of data © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e789-e790 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lionne Venderbos More articles by this author André Deschamps More articles by this author Ernst-Günther Carl More articles by this author John Dowling More articles by this author Renée Hogenhout More articles by this author Sebastiaan Remmers More articles by this author Monique Roobol More articles by this author Expand All Advertisement Loading ...

Comparing Outcomes of a Digital Commercial Weight Loss Program in Adult Cancer Survivors and Matched Controls with Overweight or Obesity: Retrospective Analysis.

Maintaining a healthy weight is beneficial for cancer survivors. However, weight loss program effectiveness studies have primarily been in highly controlled settings. This is a retrospective study exploring real-world outcomes (weight loss and program engagement) after use of a digital commercial weight loss program (Noom) in cancer survivors and matched controls. All participants had voluntarily self-enrolled in Noom. Weight and engagement data were extracted from the program. Cancer-related quality of life was secondarily assessed in a one-time cross-sectional survey for survivors. Controls were a sample of Noom users with overweight/obesity who had no history of cancer but 0–1 chronic conditions. Primary outcomes were weight change at 16 weeks and program engagement over 16 weeks. Engagement included frequency of weight, food, and physical activity logging, as well as number of coach messages. Multiple regression controlling for baseline age, gender, engagement, and BMI showed that survivors lost less weight than controls (B = −2.40, s.e. = 0.97, p = 0.01). Survivors also weighed in less (survivors: 5.4 [2.3]; controls: 5.7 [2.1], p = 0.01) and exercised less (survivors: 1.8 [3.2]; controls: 3.2 [4.1], p < 0.001) than controls. However, survivors sent more coach messages (survivors: 2.1 [2.4]; controls: 1.7 [2.0], p < 0.001). Despite controls losing more weight than cancer survivors (−7.0 kg vs. −5.3 kg), survivors lost significant weight in 4 months (M = −6.2%). Cancer survivors can have success on digital commercial programs available outside of a clinical trial. However, they may require additional support to engage in weight management behaviors.

The impact of chemotherapy-induced inner ear damage on quality of life in cancer survivors: a qualitative study

PurposeThis study aimed to explore the burden of inner ear damage (ototoxicity) on adults living with and beyond cancer treated with chemotherapy and the impact on their quality of life (QoL). Furthermore, this study aimed to explore patient awareness surrounding chemotherapy-induced inner ear damage, known as ototoxicity, and assess what support they had been offered.MethodsParticipants were adults who had undergone chemotherapy, recruited from cancer clinics, charities and social media. Using semi-structured interviews and fieldnotes, an inductive thematic analysis was used to develop key themes surrounding this topic.ResultsTwenty participants from the UK were interviewed. Two key themes were developed from the thematic analysis, cancer-related QoL and ototoxicity-related QoL, with each one including 5 subthemes. Subthemes consisted of impact of ototoxicity, hearing, tinnitus, clinical experience, audiological assessments, and impact of treatment, cancer and chemotherapy, other toxicities, information and patient reflections.ConclusionsOtotoxicity can have a negative impact on QoL, specifically on social life and the fear of hearing loss and/or tinnitus worsening. There are opportunities for increased awareness by patients and clinicians, including improved information sources, and hearing monitoring not only for those undergoing platinum-based chemotherapy but many others surviving after treatment for cancer.Implications for Cancer SurvivorsBetter monitoring of hearing and information about ototoxicity during chemotherapy could potentially reduce the fear of the symptoms of ototoxicity worsening. Furthermore, hearing monitoring would facilitate the detection of hearing loss at early stages of survivorship, which would facilitate earlier access to clinical interventions and longer term counselling.