Intensive Cancer Treatment Research Articles

Impacts of Cancer Diagnoses and Treatments on the Psychological Health of Patients

The effects that come with cancer diagnoses and treatments are many and impact various aspects of an individual’s life. A rarely talked about impact of the cancer journey is the psychological impact of cancer on patients. Individuals experience isolation, changes in social interaction, impact on their health, and financial status. Deterioration in the psychological health of cancer patients can lead to devastating effects on the overall health of the individual because when an individual’s psychological health declines, multiple other body systems are impacted too. This takes a drastic toll on patients because they already have to fight intensive cancer treatment, and a deteriorating psychological state can cause a lot of harm in their journey towards being cancer-free. Additionally, cancer patients experience much stigma from others lacking knowledge about what cancer patients go through. This can lead to cancer patients experiencing various psychological health issues which can then cause overall health-based consequences. Examining multiple credible studies regarding the psychological health of cancer patients, this paper aims to examine the role of psychological health throughout the journey of cancer diagnosis and treatment. Ultimately, there is an extensive impact on the psychological health of patients due to cancer treatment and diagnosis as a result of the stigma and environment experienced during the cancer journey. The most efficient method to help patients avoid significant psychological health deterioration is to create programs in their treatment plan to monitor their psychological health, mentally prepare them for the treatment ahead, and provide healthy coping strategies.

Cocktail hepatocarcinoma therapy by a super-assembled nano-pill targeting XPO1 and ATR synergistically

Intensive cancer treatment with drug combination is widely exploited in the clinic but suffers from inconsistent pharmacokinetics among different therapeutic agents. To overcome it, the emerging nanomedicine offers an unparalleled opportunity for encapsulating multiple drugs in a nano-carrier. Herein, a two-step super-assembled strategy was performed to unify the pharmacokinetics of a peptide and a small molecular compound. In this proof-of-concept study, the bioinformatics analysis firstly revealed the potential synergies towards hepatoma therapy for the associative inhibition of exportin 1 (XPO1) and ataxia telangiectasia mutated-Rad3-related (ATR), and then a super-assembled nano-pill (gold nano drug carrier loaded AZD6738 and 97−110 amino acids of apoptin (AP) (AA@G)) was constructed through camouflaging AZD6738 (ATR small-molecule inhibitor)-binding human serum albumin onto the AP-Au supramolecular nanoparticle. As expected, both in vitro and in vivo experiment results verified that the AA@G possessed extraordinary biocompatibility and enhanced therapeutic effect through inducing cell cycle arrest, promoting DNA damage and inhibiting DNA repair of hepatoma cell. This work not only provides a co-delivery strategy for intensive liver cancer treatment with the clinical translational potential, but develops a common approach to unify the pharmacokinetics of peptide and small-molecular compounds, thereby extending the scope of drugs for developing the advanced combination therapy.

The effect of physical exercise and dairy probiotics (Lactobacillus casei) on gut microbiome in childhood cancer survivors.

Gut microbial dysbiosis persists months after intensive cancer treatment in children and adolescents. This prospective study compared the intestinal microbiome of children 1-3 years after completion of Berlin-Frankfurt-Münster protocol (BFM)-based pediatric ALL (PALL) treatment and healthy controls. To induce a favorable shift in the bacterial composition of the intestines in PALL with gut microbiome disruptions, 8 weeks of physical activity and probiotic consumption were used. Blood analyses and 16S rRNA sequencing for the gut microbiome were performed on 16 pediatric cases and 16 healthy controls. Significant differences in bacterial diversity were found between pre- and post-intervention, respectively (Shannon index, 3.22±0.45 vs. 3.47±0.24, p=0.04; Simpson index, 0.10±0.05 vs. 0.06±0.02, p=0.02; and Chao1 index, 693.88±238.58 vs. 794.23±116.34, p=0.04). Furthermore, the increase in the relative abundance of Lactobacillus casei (5.04E-03±1.62E-02 vs. 2.92E-02±5.03E-02, p=0.04) and the increase in some strains of Veillonella, a bacterial genus recently linked to improved physical fitness, were identified. Promisingly, the exercise program combined with dairy probiotics increased bacterial richness and diversity.

Technology adoption and market allocation: The case of robotic surgery

The adoption of health care technology is central to improving productivity in this sector. To provide new evidence on how technology affects health care markets, we focus on one area where adoption has been particularly rapid: surgery for prostate cancer. Within just eight years, robotic surgery grew to become the dominant intensive prostate cancer treatment method. Using a difference-in-differences design, we show that adopting a robot drives prostate cancer patients to the hospital. To test whether this result reflects market expansion or business stealing, we also consider market-level effects of adoption and find effects that are significant but smaller, suggesting that adoption expands the market while also reallocating some patients across hospitals. Marginal patients are relatively young and healthy, inconsistent with the concern that adoption broadens the criteria for intervention to patients who would gain little from it. We conclude by discussing implications for the social value of technology diffusion in health care markets.

Toxicity of Cisplatin and Herbal Medicine Complexed with Bovine Serum Albumin (BSA) and Folic Acid Nanoparticles as Anticancer Candidates

The prevalence of cancer in Indonesia has increased by 8.8 percent in the last two years (2018 and 2020) in terms of adding new cases and mortality. Because of therefor cancer treatment becomes important in reducing the high number of additional new cases and mortality due to cancer patients. Intensive cancer treatment is by surgery, chemotherapy, radiotherapy and immunotherapy. Chemotherapy drugs used for cancer treatment include herbal plant-based cancer drugs (Cancer Fit) and cisplatin its buy from online shop. This study aims to compare the toxicity of herbal drugs (Cancer fit) with cisplatin, a combination of BSA nanoparticles and folic acid as anticancer candidates. The research method is through the synthesis of nanoparticles with the desolvation method, then characterization is carried out using XRD and FT-IR tests. After that proceed to the toxicity test with the BSLT method. The results obtained from XRD analysis on BSA and folic acid nanoparticles from cisplatin (As-NP-BSA-CP) showed a peak of 34.45 while BSA and folic acid nanoparticles from herbal medicine (As-NP-BSA-Oh) obtained a peak of 22.77. The purpose of XRD analysis was to determine the crystalline characteristics of the synthesized nanoparticles and to analyze the crystalline index. FT-IR analysis on (As-NP-BSA-CP) showed that there are functional groups O-H alcohol, C-H, C-C, NO2 that play a role in the synthesis of nanoparticles. Meanwhile, (As-NP-BSA-Oh) showed that the functional groups were C-H alkene, C-O alcohol, and C-N amine/amide. The toxicity level of As-NP-BSA-CP LC50 is 69.14 ppm while the toxicity level of As-NP-BSA-Oh LC50 is 44.14 ppm. Nanoparticles consisting of a combination of bovine serum albumin (BSA), folic acid and cisplatin drugs or herbal drugs can be used as candidates for anticancer drugs.

Toxicity of Cisplatin and Herbal Medicine Complexed with Bovine Serum Albumin (BSA) and Folic Acid Nanoparticles as Anticancer Candidates

The prevalence of cancer in Indonesia has increased by 8.8 percent in the last two years (2018 and 2020) in terms of adding new cases and mortality. Because of therefor cancer treatment becomes important in reducing the high number of additional new cases and mortality due to cancer patients. Intensive cancer treatment is by surgery, chemotherapy, radiotherapy and immunotherapy. Chemotherapy drugs used for cancer treatment include herbal plant-based cancer drugs (Cancer Fit) and cisplatin its buy from online shop. This study aims to compare the toxicity of herbal drugs (Cancer fit) with cisplatin, a combination of BSA nanoparticles and folic acid as anticancer candidates. The research method is through the synthesis of nanoparticles with the desolvation method, then characterization is carried out using XRD and FT-IR tests. After that proceed to the toxicity test with the BSLT method. The results obtained from XRD analysis on BSA and folic acid nanoparticles from cisplatin (As-NP-BSA-CP) showed a peak of 34.45 while BSA and folic acid nanoparticles from herbal medicine (As-NP-BSA-Oh) obtained a peak of 22.77. The purpose of XRD analysis was to determine the crystalline characteristics of the synthesized nanoparticles and to analyze the crystalline index. FT-IR analysis on (As-NP-BSA-CP) showed that there are functional groups O-H alcohol, C-H, C-C, NO2 that play a role in the synthesis of nanoparticles. Meanwhile, (As-NP-BSA-Oh) showed that the functional groups were C-H alkene, C-O alcohol, and C-N amine/amide. The toxicity level of As-NP-BSA-CP LC50 is 69.14 ppm while the toxicity level of As-NP-BSA-Oh LC50 is 44.14 ppm. Nanoparticles consisting of a combination of bovine serum albumin (BSA), folic acid and cisplatin drugs or herbal drugs can be used as candidates for anticancer drugs.

Protocol of trans-Tasman feasibility randomised controlled trial of the Younger Women’s Wellness After Breast Cancer (YWWACP) lifestyle intervention

BackgroundYounger women (defined as those < 50 years who are likely pre-menopausal at time of diagnosis) with breast cancer often experience persistent treatment-related side effects that adversely affect their physical and psychological wellbeing. The Women’s Wellness After Cancer Program (WWACP) was adapted and piloted in Australia to address these outcomes in younger women. The aims of this feasibility study are to determine (1) the potential to translate the Younger WWACP (YWWACP) intervention to a broader population base in Aotearoa/New Zealand and Australia, and (2) the potential for success of a larger, international, phase ΙΙΙ, randomised controlled trial.MethodsThis bi-national, randomised, single-blinded controlled trial involves two main study sites in Aotearoa/New Zealand (Kōwhai study) and Australia (EMERALD study). Young women aged 18 to 50 years who completed intensive treatment (surgery, chemotherapy, and/or radiotherapy) for breast cancer in the previous 24 months are eligible. The potential to translate the YWWACP to women in these two populations will be assessed according to several feasibility outcomes. These include examining intervention accessibility, acceptability and uptake; intervention sustainability and adherence; the prevalence components of the intervention in the control group; intervention efficacy; participants’ perception of measurement burden; the effectiveness of planned recruitment strategies; and trial methods and procedures. The studies collectively aim to enrol 60 participants in the intervention group and 60 participants in the control group (total = 120 participants).DiscussionEthical approval has been received from the Southern Health and Disability Ethics Committee (Kōwhai ref: 19/STH/215), and UnitingCare Human Research Ethics Committee (EMERALD ref: 202103). This study will provide important data on the feasibility of the refined YWWACP in the trans-Tasman context. This study will account for and harmonise cross-country differences to ensure the success of a proposed international grant application for a phase ΙΙΙ randomised controlled trial of this program to improve outcomes in younger women living with breast cancer.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): Kōwhai ACTRN12620000260921, registered on 27 February 2020. EMERALD ACTRN12621000447853, registered on 19 April 2021.

Feasibility study of integrated ePROs in routine care during radiation therapy for head and neck cancer.

e13612 Background: Use of electronic Patient Reported Outcomes (ePRO) tools in the routine care of cancer patients remains challenging despite data showing that they can improve resource utilization and patient outcomes. Patients with head and neck cancer during intensive therapy with radiation therapy (RT) may particularly benefit from interventions focused on early symptom management. Methods: 34 patients with head and neck cancer were enrolled in an implementation study and received ePROs integrated within the electronic medical record (EMR) weekly during radiation therapy (RT) within a large integrated health care delivery system. ePROs consisted of the FACT G7 and FACT-HN. After completion of each survey on the patient portal, a radiation oncology RN documented any abnormal findings and subsequent interventions using a standardized format within the EMR. If patients did not have access to the patient portal or had language barriers, they could complete ePROs with a translator by phone or video. Results: Between January and December of 2021, 34 patients with head and neck cancer receiving curative RT were enrolled. The median age 65 years (range 46-84). 74% of patients were male. 59% were white, 26% Asian/PI, 5% Black, and 5% Hispanic. The most common primary cancer sites were: oropharynx (32%), nasopharynx (24%), larynx (18%), oral cavity (9%). 65% of patients received concurrent chemotherapy with RT and 35% received RT alone. 97.4% of patients had access to the online portal. The total number of surveys completed was 194 with a median of 7 per patient (range 1-8). There was a total of 887 abnormal findings reported and 887 documented and corresponding interventions resulting in a 100% intervention rate. Over the course of RT the mean number of abnormal findings increased from 2.26 at baseline (n = 34) to 6.27 at week 7 (n = 24), P &lt; 0.0001. Hospitalizations and Emergency Department (ED) visit data were collected during the study and up to 30 days from last day of RT. There was a total of 2 hospitalizations and 8 ED visits. Conclusions: ePROs integrated within the patient portal and EMR are feasible during RT for patients with head and neck cancer within a large integrated health care system. The use of ePROs integrated within the patient portal and EMR can lead to a high rate of intervention. The increasing number of abnormal findings on ePRO during intensive treatment for head and neck cancer is consistent with known patterns of toxicity and confirm the value of studying methods for improving quality of life in this patient population.[Table: see text]

Cancer treatment and decision making in individuals with intellectual disabilities: a scoping literature review.

Adults with intellectual disabilities face disparities in receipt of cancer-related care, which could contribute to an increase in the rate of cancer-related deaths in this population. Yet, relatively little is known about the optimal cancer treatment or treatment decision making in adults with intellectual disabilities. This scoping review assessed PubMed and Embase for available literature on the description of cancer treatment and treatment decision making in patients with intellectual disabilities, published in English between Jan 1, 2000, and April 30, 2020. We appraised 90 included articles and extracted quotes addressing aspects related to cancer treatment and treatment decision making in patients with intellectual disabilities. Themes and subcategories were subsequently derived. Our findings revealed that the available literature describes that people with intellectual disabilities tend to have less intensive cancer treatment than generally administered, but with little evidence supporting this approach. This finding indicates that this medically vulnerable patient population needs tailored attention in both cancer care and research. We propose changes to practice and conclude by addressing the urgent need to pay specific attention to this patient population.

Clinical and radiological features of COVID-19 infection in pediatric hematology-oncology and transplant patients

Purpose: The goal of this study is to explain the characteristics of COVID-19 in this demographic, as well as the impact it had on pediatric cancer care during the pandemic. &#x0D; Materials and Methods: Fifteen COVID-19 patients diagnosed were studied retrospectively. Clinical, laboratory and radiological data were collected in relation to 15 patients under the age of 18 who tested positive for Sars-CoV-2. &#x0D; Results: Of the 12117 pediatric hemato-oncological patients tested for COVID-19, 1125 patients showed symptoms, and 14 tested positive. The majority of cases suffered minor illnesses. A total of ten children required inpatient care, five needed oxygen support, and four required mechanical ventilation and later died. It was noted that the duration of real-time polymerase chain reaction (RT-PCR) positivity was prolonged in patients receiving intensive chemotherapy and/or immunosuppressive therapy. Patients’ chemotherapy was delayed in all 15 (100%) Sars-CoV-2-positive patients. Although changes visible on chest computed tomography (CT) imaging of children were mainly milder than in adults, radiological findings were more severe in patients who received relatively intensive cancer treatment. &#x0D; Conclusion: Children who have been treated for cancer or who have undergone a hematopoietic stem cell transplantation (HSCT) may be at greater risk of severe COVID-19 and should be under constant observation.

Effect Of Frailty And Exercise On Fatigue, Physical Activity, Functional Ability And Muscle Strength In Adult Hematopoietic Cell Transplantation Recipients

PURPOSE: Intensive cancer treatment followed by hematopoietic cell transplantation results in moderate to severe fatigue, physical inactivity, diminished functional ability, and reduced muscle strength. These alterations may be magnified by frailty status. This study compared the effects of frailty (not frail, pre-frail, and frail) and exercise (strength training, n = 33, compared to attentional control with health education, n = 34) in adult hematopoietic cell transplantation recipients. Dependent variables included fatigue, physical activity, functional ability and muscle strength. METHODS: Subjects were randomly stratified by type of transplant (allogeneic or autologous) and age (≤ 60 years of age or > 60 years of age) in this single-blind randomized clinical trial. The strength training intervention consisted of a comprehensive program of progressive resistance introduced during hospitalization and continued for six weeks following hospital discharge. Subjects assigned to attention control with health education subjects received weekly health education post hospitalization. A composite frailty score was based on unexplained weight loss, poor hand-grip strength, self-reported exhaustion, slow walking speed, and low physical activity. Variables were assessed six weeks following hospital discharge. MANOVA was used to analyze the data. RESULTS: A significant interaction effect (frailty x exercise) was noted for fatigue, p = .007. Frail subjects in the health education with attention control group reported more overall fatigue compared to the strength training group, p = .04. Frail subjects in the health education with attention group reported more mental fatigue compared to the strength training group, p = .008. Significant frailty main effects were revealed for physical activity (p = .001), functional ability (p = .025), and muscle strength (p = .002). No significant main effects for exercise were identified. CONCLUSIONS: Strength training compared to health education with attentional control improved overall and mental fatigue in those who were frail. As expected, differences in physical activity, functional ability, and muscle strength were noted between frail, pre-frail and not frail hematopoietic cell transplantation recipients.

Fear of progression in parents of childhood cancer survivors: prevalence and associated factors

PurposeRecent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers.MethodsFive hundred sixteen parents of pediatric cancer survivors (aged 0–17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models.ResultsSignificantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001).ConclusionsFoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP.Implications for Cancer SurvivorsPsychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.

Sexual dysfunction in young adult survivors of childhood cancer – A population-based study

ObjectiveTo determine the prevalence of sexual dysfunction and to identify the factors associated with sexual dysfunction in young adult childhood cancer survivors. MethodsAll survivors of childhood cancer (aged 19–40 years) in Sweden were invited to this population-based study, and 2546 men and women (59%) participated. Sexual function was examined with the PROMIS Sexual Function and Satisfaction Measure. Logistic regression was used to assess the differences between survivors and a general population sample (n = 819) and to identify the factors associated with sexual dysfunction in survivors. ResultsSexual dysfunction in at least one domain was reported by 57% of female and 35% of male survivors. Among females, dysfunction was most common for Sexual interest (36%), Orgasm – ability (32%) and Vulvar discomfort – labial (19%). Among males, dysfunction was most common for the domains satisfaction with sex life (20%), Sexual interest (14%) and Erectile function (9%). Compared with the general population, male survivors more frequently reported sexual dysfunction in ≥2 domains (OR = 1.67, 95% CI: 1.03–2.71), with an increased likelihood of dysfunction regarding Orgasm – ability (OR = 1.82; 95% CI: 1.01–3.28) and Erectile function (OR = 2.30; 95% CI: 1.18–4.49). Female survivors reported more dysfunction regarding Orgasm – pleasure (9% versus 5%, OR = 1.86; 95% CI: 1.11–3.13). A more intensive cancer treatment, emotional distress and body image disturbance were associated with sexual dysfunction in survivors. ConclusionsThe findings underscore the need for routine assessment of sexual health in follow-up care of childhood cancer survivors and highlight that those treated with more intensive cancer treatment and who experience concurrent psychological concerns may benefit from targeted screening and interventions.

Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study.

Objectives: Substance use among young adult childhood cancer survivors (YACCSs) has been found to increase during survivorship, resulting in increased risk of developing long-term negative health outcomes. This investigation sought to determine various risk and protective factors of tobacco, alcohol, or marijuana use over time among a sample of YACCSs. Methods: 127 YACCSs (57% Hispanic, 55% female, average age at diagnosis 12.4 years) who were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical centers in Los Angeles County between 2000 and 2007 responded to two surveys separated by ∼5 years. Bivariate logistic regression models were used to assess independent clinical and psychosocial Time 1 variables associated with each substance use outcome at Time 2. Time 1 variables significant at p < .10 were included in multivariable logistic regression models for each Time 2 substance use variable. Results: Rates of 30-day use increased over time for binge drinking alcohol (from 25.6% to 37.7%), marijuana (from 10.6% to 22.1%), and cigarette/tobacco (from 8.9% to 12.2%). Of the following Time 1 variables, marijuana use, cigarette use, and binge drinking were associated with Time 2 marijuana, cigarette, and binge drinking, respectively. Of the following clinical factors, receipt of more intensive cancer treatment was associated with decreased tobacco use. All other psychosocial and clinical factors analyzed were not associated with any increase or decrease in substance use. Conclusions: A greater emphasis on early health education efforts regarding the health risks of tobacco, alcohol, and marijuana use is needed in this at-risk population.

Technology Adoption and Market Allocation:The Case of Robotic Surgery

The adoption of healthcare technology is central to improving productivity in this sector. To provide new evidence on how technology affects healthcare markets, we focus on one area where adoption has been particularly rapid: surgery for prostate cancer. Over just six years, robotic surgery grew to become the dominant intensive prostate cancer treatment method. Using a difference-in-differences design, we show that adopting a robot drives prostate cancer patients to the hospital. To test whether this result reflects market expansion or business stealing, we also consider market-level effects of adoption and find they are significant but smaller, suggesting that adoption expands the market while also reallocating some patients across hospitals. Marginal patients are relatively young and healthy, inconsistent with the concern that adoption broadens the criteria for intervention to patients who would gain little from it. We conclude by discussing implications for the social value of technology diffusion in healthcare markets.

Psychological and Behavioral Impacts of Breast Cancer on Survivors​

More than 3.8 million people with a history of breast cancer were reported to be alive in 2019, and about 150,000 of these people are currently living with metastatic disease. Based on recent data, the survival rate for breast cancer survivors is 91% after 5 years, 84% after 10 years, and 80% after 15 years. The purpose of this research article is to review how breast cancer can influence patients’ mental health status while in remission and to emphasize the importance of survivorship resources for these patients after stopping intensive cancer treatment. Mental health serves as a balance of emotional wellbeing and maintaining a harmonic internal equilibrium state. However, due to intensive therapies, treatments, and post-traumatic stress, a breast cancer survivor may have difficulties with being in a healthy mental state. The causes for depression, “chemo brain”, and mood changes will be discussed in relation to breast cancer treatment and survivorship. Three resources that are crucial to helping a patient adjust to the multitude of emotions and the new “normal” in their lives have been identified: psychiatric oncologists, survivorship clinics, and personalized plans for recovery. The review article will explore the purpose and importance of each of these resources.

Undertreatment and overtreatment in older patients treated with chemotherapy

BackgroundInconsistent doses and schemes are commonly used in older patients receiving cancer chemotherapy. We performed this study in patients with cancer and age ≥ 70 years to determine the frequency of undertreatment and overtreatment as well as factors influencing the decision to modify chemotherapy doses. Patients and MethodsPatients aged ≥70 years starting new chemotherapy regimens were prospectively included in a multicentre study. The schedule and drug doses were determined by the treating oncologist. Pre-chemotherapy assessment included sociodemographics, treatment details and geriatric assessment (GA) variables. Association between these factors and undertreatment (use of less intensive cancer treatment [LICT] in a fit patient) or overtreatment (use of standard cancer treatment in an unfit older patient) were examined by multivariate logistic regression. ResultsThree- hundred ninety-seven patients were included, 43% of whom received LICT. If not adjusted for GA, toxicity did not differ between those receiving LICT (38%) or standard doses of chemotherapy (37%). If the dose of chemotherapy was analyzed according to the results of GA 61 (15%) patients had been undertreated and 133 (34%) had been overtreated. Undertreatment was related with increasing age and decreased renal function. Factors related with overtreatment were younger age, curative intention of treatment, prescription of G-CSF as primary prophylaxis and adequate cognitive status. Overtreated patients had more grade 3–4 toxicity than those receiving treatment adapted to fragility (42% vs 31%; p < 0.05). ConclusionsThe use of chemotherapy without considering GA leads to overtreatment more commonly than undertreatment in older patients with cancer. Oncologists should take into account the results of GA to stratify patients and to avoid under or overtreatment.

Health Behaviors of Chinese Childhood Cancer Survivors: A Comparison Study with Their Siblings.

Purpose: This study aimed to compare health behaviors between the childhood cancer survivors (CCS) and their sibling controls and to examine the pattern of health behaviors of the Hong Kong Chinese CCS and its associations with their health-related quality of life and psychological distress. Methods: A cross-sectional telephone survey was conducted. A total of 614 CCS and 208 sibling controls participated in this study. Patterns of health behaviors including lifestyle behaviors, cancer screening practices, and insurance coverage were compared. Multivariate regression analyses were performed for examining factors associated with health behaviors in CCS. Results: CCS had less alcohol consumption when compared with their sibling controls (adjusted odds ratio (AOR) = 0.65, p = 0.035). The sibling controls were more likely to have cancer screening practices (AOR = 0.38, p = 0.005) and health (AOR = 0.27, p < 0.001) and life insurance coverage (AOR = 0.38, p < 0.001). Among the CCS, those who were male, having a job or higher education, shorter time since diagnosis, and type of cancer suffered were significantly associated with alcohol consumption. Those CCS who were drinkers indicated poorer mental health (p = 0.004) and more psychological distress. Female CCS undertaking cancer screening were more likely to be employed, married/cohabiting, and have received intensive cancer treatment. Conclusion: This study reveals that Chinese childhood cancer survivors are less likely to engage in unhealthy lifestyle behaviors, insurance coverage and cancer screening, when compared with their siblings. Implications for Cancer Survivors: It is crucial for healthcare professionals to identify strategies or target interventions for raising CCS’s awareness of their cancer risks and healthy lifestyle throughout their life.

Fear of progression in parents of childhood cancer survivors: A dyadic data analysis.

Fear of progression (FoP), also referred to as fear of cancer recurrence, is gaining increasing interest in survivorship research as it constitutes a great burden for patients and relatives. However, only little is known about FoP in parents of childhood cancer survivors. The objective of this study was to investigate the impact of FoP on quality of life (QoL) in parental couples. We analyzed dyadic data of 197 couples parenting childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumor) after the end of intensive cancer treatment. The actor-partner interdependence model calculated by structural equation modelling was used to examine actor effects (effect of one's own FoP on one's own QoL) and partner effects (effect of one's own FoP on the partner's QoL). Eighty-one percentage of the parents reported moderate or high FoP levels. Mothers reported higher FoP levels (p < .01) and lower overall QoL levels than fathers (p < .01). The results revealed a significantly positive intra-dyadic correlation between FoP of mothers and fathers of the same dyad (r = .431, p < .001). We found significantly negative actor effects for both mothers and fathers for the overall QoL (p < .001) as well as for several QoL subscales. No significant partner effects were found. Most parents reported elevated levels of FoP. Our results show that FoP in parents of childhood cancer survivors is strongly negatively associated with QoL. Parental FoP should therefore be explored in future research and needs to be targeted by health care providers.

Cancer and COVID-19: Patients' and psychologists' reflections regarding psycho-oncology service changes.

Cancer and COVID-19: Patients' and psychologists' reflections regarding psycho-oncology service changes.