Survivors Of Other Types Research Articles

QOL-33. CANCER WORRY AND PSYCHOPATHOLOGICAL SYMPTOMS IN ADOLESCENTS AND YOUNG ADULTS SURVIVORS OF PEDIATRIC BRAIN TUMORS

Abstract BACKGROUND Adolescent and young adult (AYA) survivors of pediatric brain tumors may experience cancer-related worries, defined as concerns about relapse and late effects of treatment. Late psychological effects include psychological distress, depression, immaturity, and poor development of social skills. Furthermore, pediatric brain tumor survivors (PBTS) are more vulnerable to developing long-term neurocognitive and psychosocial consequences compared both to the general population and survivors of other types of childhood cancer. The purpose of the study was to identify the presence of cancer worry and psychopathological symptoms in AYA survivors of pediatric brain tumors. METHODS AYA survivors were assessed using the Cancer Worry Scale and Child Behavior Checklist questionnaires. Neurocognitive evaluation was performed using the age-appropriate Wechsler Scale. RESULTS Among 22 AYA survivors (M =14; F=8), the diagnosed tumor types were: germ cell tumor (10/22), low-grade glioma (4/22), embryonal tumor (3/22), high-grade glioma (2/22), craniopharyngioma (2/22), and mesenchymal tumor of the meninges (1/22). Survivors received the assessment at a median age of 20.2 years (range 13.6-28.7), with a median of 92 months after diagnosis. Cancer worry was reported in 50% of patients. The psychological evaluation showed clinical levels of internalizing problems in 17% and externalizing problems in 8%. Depressive and anxiety problems were reported in 25% of our cohort. Neurocognitive assessment demonstrated an average tIQ of 104. CONCLUSIONS As reported in the literature, cancer worry can influence the psychosocial adjustment process, alter self-image, and influence lifestyle decisions in PBTS. These concerns can affect their life prospects and their ability to successfully complete developmental tasks. Therefore, these issues must be early identified to prevent, through targeted psychosocial interventions, the onset of troubles in having romantic relationships, finishing school, entering the job market, and obtaining a good quality of life.

The development of fatigue after treatment for pediatric brain tumors does not differ between tumor locations.

Children and adolescents treated for a brain tumor suffer from more fatigue than survivors of other types of childhood cancer. As tumor location might be predictive of fatigue, our aim was to investigate the longitudinal development of fatigue in children with brain tumors and risk factors for fatigue separately for different tumor locations. Fatigue was assessed 1235 times for 425 participants. Self-report versions of PedsQL Multidimensional Fatigue Scale were used to repeatedly assess fatigue from the end of treatment up to 8years later. Mixed models were used to analyze fatigue over time and determinants separately for infratentorial (N=205), supratentorial hemispheric (N=91), and supratentorial midline tumors (N=129). Cognitive fatigue worsened with time, while sleep-rest and general fatigue first decreased and then increased. There was no difference in fatigue between the tumor locations, but the risk factors differed when stratified by location. Radiotherapy was associated with more fatigue for infratentorial tumors, and centralization of care was associated with less fatigue for the supratentorial midline tumors. For supratentorial hemispheric tumors, female sex was associated with more fatigue. Higher parental education was associated with less fatigue regardless of tumor location. The development of fatigue seems to be more related to sociodemographic and treatment variables than to tumor location. Healthcare providers need to be aware that fatigue may develop in the years following end of treatment, and that patients with a low/middle educational family background might be more vulnerable and in need of targeted support.

Preventive Behaviors Among Leukemia and Lymphoma Cancer Survivors: Results From the 2020 Behavioral Risk Factor Surveillance System Survey

Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for cancer survivors. Health behaviors, such as engaging in physical activity, not consuming large amounts of alcohol, abstaining from cigarette smoking, receiving routine immunizations, and undergoing recommended cancer screening tests, may lead to improved physical health, health status, and quality of life. We examined preventive behaviors among hematologic cancer survivors in a cross-sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System. Adherence to cancer screening test and immunization recommendations among hematologic cancer survivors compares favorably with that among persons with no history of cancer. However, no statistically significant differences in the frequency of current smoking, heavy drinking, and physical activity were observed across these 2 groups. No important differences were observed in health behaviors between male and female cancer survivors, except that female hematologic cancer survivors were more likely to adhere to influenza and pneumococcal pneumonia immunization recommendations than female survivors of other types of cancer, whereas no such differences were found among their male counterparts. Although hematologic cancer survivors were more adherent to preventive health behaviors such as cancer screening and immunization, they were not different from persons without any history of cancer in exhibiting behavioral risk factors such as smoking and heavy drinking. Intervention studies are needed to identify effective ways to assist hematologic cancer survivors to quit smoking and refrain from hazardous alcohol consumption.

Cardiovascular conditions and obesity among gynecologic cancer survivors: Results from the 2020 behavioral risk factor surveillance system survey

BackgroundWith the increasing prevalence of gynecologic cancer and obesity, there is a growing population living with cardiovascular disease, obesity and gynecologic cancer concurrently or at risk of developing these disease states. MethodsWe examined cardiovascular (CV) conditions and obesity among 1824 gynecologic cancer survivors in a cross-sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS). Univariate and multivariable logistic regression methods were used in the analysis. ResultsThe prevalence of heart attack, CHD, and stroke were significantly higher (p < 0.001) among survivors of gynecologic and other cancer survivors compared to women with no history of cancer. However, no statistically significant differences were observed across gynecologic and other cancer survivors. The prevalence of obesity among gynecologic cancer survivors was significantly higher (p < 0.001) than that in the other two groups. While around one-third of the women with no history of cancer and survivors of other types of cancer were obese, obesity prevalence was nearly 13%-points higher among survivors of gynecologic cancer. In multivariate analysis, gynecologic cancer survivors were 2.7 times more likely to have a heart attack compared to those without any history of cancer. The odds of CHD and stroke among survivors of gynecologic cancer were respectively 3.4 and 2.7 times that of those with no history of cancer. The adjusted odds were also similar, though smaller in magnitude. Gynecologic cancer survivors were also more likely to be obese −1.8 times that of those with no cancer. ConclusionsGynecologic cancer survivors are more likely than persons without a cancer history to have cardiovascular disease and other chronic illnesses, and they have a higher prevalence of heart attack, stroke, and obesity. These results underscore the sizeable opportunities for primary, secondary, and tertiary prevention of cardiovascular health conditions among gynecologic cancer survivors.

La croissance post-traumatique chez les victimes de violences conjugales : une étude pilote dans la Vienne

ObjectiveThis study aimed to: (1) evaluate posttraumatic growth in survivors of intimate partner violence, (2) compare and characterize this posttraumatic growth with the one measured in survivors of other types of violence, and (3) evaluate post-traumatic stress disorder and its relationship with posttraumatic growth in our clinical population. MethodsWe realized a monocentric pilot study in Poitiers (Vienne, France) recruiting 17 survivors of intimate partner violence and 42 survivors of other types of violence from two medical departments: the Unit of Forensic Medicine, where victims are oriented following complaints, and the Psychotrauma Center. Participants were administrated questionnaires comprising socio-demographics data and specific scales, namely the PTGI and PCL-5. ResultsWe found a higher prevalence of posttraumatic growth in survivors of intimate partner violence (82 %), when compared with survivors of sexual assault and other interpersonal types of violence (52 % and 53 %, respectively). Posttraumatic growth was low to moderate, and faster as it was detected in victims recruited in the Unit of Forensic Medicine. All domains of posttraumatic growth were positively affected, i.e. higher scores from the PTGI were recorded in survivors of intimate partner violence. No difference was found when results were compared between groups from the Psychotrauma Center. We were unable to identify socio-demographic predictors of posttraumatic growth. À posttraumatic stress disorder was found in survivors of intimate partner violence, and negatively related to posttraumatic growth. DiscussionTo our knowledge, this is the first study comparing post-traumatic growth across such conditions and using specific and recognized scales. Our pilot study demonstrated that survivors of intimate partner violence were able to develop low to moderate posttraumatic growth faster than survivors of other types of violence. All domains of posttraumatic growth were affected, demonstrating the ability of survivors to withstand adversity. Scientific data regarding the link between posttraumatic growth and posttraumatic stress disorder is unclear, probably depending on the trauma, the circumstances, the timing of the measurement. In our study, we found a clear negative correlation between the two parameters. Our results underline the necessity to provide overall and rapid intervention in survivors of intimate partner violence, comprising legal, psychological, social and medical approaches, to facilitate the development of posttraumatic growth.

Aspectos psicosociales de la calidad de vida en supervivientes pediátricos de tumores en el sistema nervioso central

Introducción: Los supervivientes de tumores del sistema nervioso central (TSNC) presentan peor calidad de vida en relación a la salud (CVRS) que los supervivientes de otras neoplasias y la población normativa. El tipo y gravedad de las secuelas no parecen tener un impacto claro en la CVRS, pero la afectación del cociente intelectual (CI) sí podría modular la CVRS. Además, las estrategias de afrontamiento del paciente y de los progenitores y el malestar emocional parental podrían también actuar sobre la CVRS. Objetivo: Determinar si las estrategias de afrontamiento del adolescente y su CI, y las estrategias de afrontamiento, el estrés general y el malestar emocional parental, modulan las dimensiones psicosociales de la CVRS del superviviente. Método: Estudio transversal descriptivo-correlacional. Se reclutaron 37 adolescentes (12-19 años) que llevaban ≥1 año fuera de tratamiento oncológico y 44 progenitores. Resultados: En la CVRS valorada por los adolescentes, las dimensiones Relación con los Padres y Vida Familiar, Amigos y Apoyo Social, y Entorno Escolar dependen de la estrategia de afrontamiento de resolución del problema usada por el adolescente. La dimensión Aceptación Social depende del estilo de afrontamiento improductivo del adolescente y del estilo de búsqueda de ayuda social de los padres. La CVRS valorada por los padres depende de las secuelas, el CI del adolescente y, el tipo de tratamiento oncológico recibido. Discusión y conclusiones: Las estrategias de afrontamiento centradas en la resolución del problema, deben ser consideradas para valorar e intervenir en la mejora de la CVRS de los supervivientes TSNC.

Participation in and adherence to physical exercise after completion of primary cancer treatment.

BackgroundThe purpose of this study was to identify demographic, clinical, psychosocial, physical and environmental factors that are associated with participation in and adherence to a combined resistance and endurance exercise program among cancer survivors, shortly after completion of primary cancer treatment. Data from the randomized controlled Resistance and Endurance exercise After ChemoTherapy (REACT) study were used for this study.MethodsThe participants of the REACT study were randomly allocated to either a high intensity (HI) or low-to-moderate intensity (LMI) exercise program. Patients’ participation rate was defined as the cancer survivors’ decision to participate in the REACT study. Exercise adherence reflected participants’ attendance to the scheduled exercise sessions and their compliance to the prescribed exercises. High session attendance rates were defined as attending at least 80 % of the sessions. High compliance rates were defined as performing at least of 90 % of the prescribed exercise across all sessions. Correlates of exercise adherence were studied separately for HI and LMI exercise. Demographic, clinical, and physical factors were assessed using self-reported questionnaires. Relevant clinical information was extracted from medical records. Multivariable logistic regression analyses were applied to identify correlates that were significantly associated with participation, high session attendance, high compliance with resistance and high compliance with endurance exercises.ResultsParticipants were more likely to have higher education, be non-smokers, have lower psychological distress, higher outcome expectations, and perceive more exercise barriers than non-participants. In HI exercise, higher self-efficacy was significantly associated with high session attendance and high compliance with endurance exercises, and lower psychological distress was significantly associated with high compliance with resistance exercises. In LMI exercise, being a non-smoker was significantly associated with high compliance with resistance exercises and higher BMI was significantly associated with high compliance with resistance and endurance exercises. Furthermore, breast cancer survivors were less likely to report high compliance with resistance and endurance exercises in LMI exercise compared to survivors of other types of cancer. The discriminative ability of the multivariable models ranged from 0.62 to 0.75.ConclusionSeveral demographic, clinical and psychosocial factors were associated with participation in and adherence to exercise among cancer survivors. Psychosocial factors were more strongly associated with adherence in HI than LMI exercise.Trial registrationThis study was registered at the Netherlands Trial Register [NTR2153] on the 5th of January 2010.

Risk Factors, Preventive Practices, and Health Care Among Breast Cancer Survivors, United States, 2010.

IntroductionWe compared behavioral risk factors and preventive measures among female breast cancer survivors, female survivors of other types of cancers, and women without a history of cancer. Survivorship health care indicators for the 2 groups of cancer survivors were compared.MethodsUsing data from the 2010 Behavioral Risk Factor Surveillance System, we calculated the proportion of women with risk factors and their engagement in preventive practices, stratified by cancer status (cancer survivors or women with no history of cancer), and compared the proportions after adjusting for sociodemographic characteristics.ResultsA significantly higher proportion of breast cancer survivors had mammography in the previous year (79.5%; 95% confidence interval [CI], 76.0%–83.0%) than did other cancer survivors (68.1%; 95% CI, 65.6%–70.7%) or women with no history of cancer (66.4%; 95% CI, 65.5%–67.3%). Breast cancer survivors were also more likely to have had a Papanicolaou (Pap) test within the previous 3 years than women with no history of cancer (89.4%; 95% CI, 85.9%–93.0 vs 85.1%; 95% CI, 84.4%–85.8%) and a colonoscopy within the previous 10 years (75.4%; 95% CI, 71.7%–79.0%) than women with no history of cancer (60.0%; 95% CI, 59.0%–61.0%). Current smoking was significantly lower among survivors of breast cancer (10.3%; 95% CI, 7.4%–13.2%) than other cancer survivors (20.8%; 95% CI, 18.4%–23.3%) and women with no history of cancer (18.3%; 95% CI, 17.5%–19.1%). After adjusting for sociodemographic characteristics, we found that breast cancer survivors were significantly more likely to have had mammography, a Pap test, and colonoscopy, and less likely to be current smokers.ConclusionBreast cancer survivors are more likely to engage in cancer screening and less likely to be current smokers than female survivors of other types of cancer or women with no history of cancer.

Quality of Life in Thyroid Cancer is Similar to That of Other Cancers with Worse Survival.

The incidence of thyroid cancer is increasing. As such, the number of survivors is rising, and it has been shown that their quality of life (QOL) is worse than expected. Using results from the North American Thyroid Cancer Survivorship Study (NATCSS), a large-scale survivorship study, we aim to compare the QOL of thyroid cancer survivors to the QOL of survivors of other types of cancer. The NATCSS assessed QOL overall and in four subcategories: physical, psychological, social, and spiritual well-being using the QOL-Cancer Survivor (QOL-CS) instrument. Studies that used the QOL-CS to evaluate survivors of other types of cancers were compared to the NATCSS findings using two-tailed t tests. We compared results from NATCSS to QOL survivorship studies in colon, glioma, breast, and gynecologic cancer. The mean overall QOL in NATCSS was 5.56 (on a scale of 0-10, where 10 is the best). Overall QOL of patients with thyroid cancer was similar to that of patients with colon cancer (mean 5.20, p=0.13), glioma (mean 5.96, p=0.23), and gynecologic cancer (mean 5.59, p=0.43). It was worse than patients surveyed with breast cancer (mean 6.51, p<0.01). We found the self-reported QOL of thyroid cancer survivors in our study population is overall similar to or worse than that of survivors of other types of cancer surveyed with the same instrument. This should heighten awareness of the significance of a thyroid cancer diagnosis and highlights the need for further research in how to improve care for this enlarging group of patients.

Cardiorespiratory Fitness in Survivors of Pediatric Posterior Fossa Tumor

Advances in medical therapies have greatly improved survivorship rates in children diagnosed with brain tumor; as a result, morbidities associated with survivorship have become increasingly important to identify and address. In general, pediatric posterior fossa tumor survivors tend to be less physically active than peers. This may be related to late effects of diagnosis and treatment, including cardiovascular, endocrine, psychological, and neurocognitive difficulties. Exercise has been shown to be effective in improving physical functioning, mood, and even cognitive functioning. Consequently, the benefits of physical exercise need to be explored and incorporated into the daily lives of pediatric posterior fossa tumor survivors. The primary aim of the present study was to establish the feasibility and safety of cardiorespiratory fitness testing in pediatric posterior fossa tumor survivors who had received cranial radiation therapy. In addition, comparing our cohort with previously published data, we found that pediatric posterior fossa tumor survivors tended to be less fit than children with pulmonary disease and healthy controls and approximately as fit as children with chronic heart disease and survivors of other types of childhood cancer. The importance of cardiorespiratory fitness in pediatric posterior fossa tumor survivors is discussed along with implications for future directions.

PTSD symptoms in a cohort of National Guard soldiers deployed to Iraq: Evidence for nonspecific and specific components

There is evidence that some of the symptoms included under the current diagnostic criteria for PTSD are not unique to PTSD and instead represent general distress. This study attempted to delineate the nonspecific and specific components of PTSD by examining the relation of PTSD symptoms to trauma exposure and demoralization in a cohort of National Guard soldiers deployed to Iraq. Data were collected from a cohort of 348 combat deployed National Guard soldiers participating in the readiness and resilience in National Guard soldiers (RINGS) study. Current DSM-IV PTSD diagnoses and trauma exposure were determined 6 to 12 months following soldiers' return from deployment using the Clinician Administered PTSD Scale. Level of trauma exposure (as measured by a combat exposure scale), demoralization and self-reported PTSD symptoms were assessed with self-report questionnaires. Dysphoria symptoms had the weakest relation with trauma exposure and the strongest relation with demoralization. In addition, these symptoms had high rates of endorsement in a group of soldiers without trauma exposure. Intrusions were strongly related to trauma and were significantly higher in the group with trauma exposure compared to the no-trauma group. These findings may not generalize to survivors of other types of trauma, service members from other era's, or even service members from different regions or military branches who have different demographic and duty characteristics. Emphasizing symptoms of PTSD that are strongly related to trauma exposure will be important for the differential diagnosis of PTSD.

Physical Exercise to Enhance Quality of Life Among Adult Cancer Survivors: An Evidence-Based Review

The goal of this evidence based review was to assess the evidence of exercise effect on quality of life (QoL) in cancer survivors. Methods: Literature search were in: CINAHL, Science direct, Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, EMBASE, and Google search engine. Keywords were: cancer (oncology, malignancy), exercise (sport, physical activity), survivors (living with cancer, curable). Only English language articles were accepted. All included studies were assessed for level of evidence. Results: Nine articles were included: two systematic review, one meta analysis, one trial, one case report, and four cross-sectional. Results of included studies showed strong evidence that physical exercise can enhance QoL among cancer survivors. Conclusion: A program of moderate/ vigorous physical exercise for 30-60 minutes, 3-5 days per week; can be helpful to enhance QoL among breast and prostate cancer survivors, although there is an evidence that exercise are effective to enhance QoL in survivors of other types of cancer (Colorectal, Ovarian, Hodgkin's lymphoma, Lung, and Head and neck); but more studies are needed; to confirm this evidence.

Coordination of Care in Breast Cancer Survivors: An Overview

The number of breast cancer survivors in the United States is increasing. With longer survival, there has been an increase in the complexity and duration of posttreatment care. Multidisciplinary care teams are needed to participate across the broad spectrum of issues that breast cancer survivors face. In this setting, the need for well-established patterns of communication between care providers is increasingly apparent. We have created a multidisciplinary approach to the management of breast cancer survivors to improve communication and education between providers and patients. This approach could be extended to the care and management of survivors of other types of cancer.

Predictors of posttraumatic stress in children and adolescents

We investigated the association between PTSD symptom levels and sociodemographic characteristics, earthquake survival, and related losses, and post-earthquake life events 4 years after two major earthquakes in Turkey in a sample of children and adolescents who emigrated from the devastated area. The study subjects consisted of 1999 earthquake survivors who moved to Ankara, Turkey, at the time of the study. The inclusion criteria included age ranging from 8 to 18 years and the absence of a serious cognitive or mental disorder that would interfere with response to self-report questionnaires. Regarding the earthquake experiences, unexpectedly, the findings indicate a significant association between posttraumatic stress, depression, fear and avoidance symptoms and only one of five subscales of Earthquake Experiences Scale, namely Functionality, even after controlling for the post-earthquake life events. Impact of earthquake was not found to predict psychological symptoms. Children and adolescents' subjective perception of the earthquake was an associated factor with higher posttraumatic stress and depression scores. Impact of earthquake was not found to predict psychological symptoms. We conclude that the level of PTSD symptoms in children and adolescents who survived a major earthquake is determined by the negative impact of the trauma on functionality and the degree of subjective negative perception about earthquake. Additional studies of PTSD in survivors of other types of major trauma are required to provide the interventions most effective for those individuals.

Responses following Suicide and Other Types of Death: The Perspective of the Bereaved

In order to compare the bereavement experience following different types of death, fifty-seven university students who had recently lost a friend or relative by suicide, accident, homicide, natural anticipated death, or natural unanticipated death were interviewed about their reactions and how they were treated by others. Those bereaved through suicide appeared to share a common core of experiences with all other groups, particularly as compared to those bereaved through accidental deaths. However, those bereaved through either suicidal or accidental deaths, more than survivors of other types of death, said that people treated them differently after the death; those bereaved through accidents listed more positive responses from others than did those bereaved through suicide. Those bereaved through suicide were unique in saying they were expected to explain the nature of the death to others in the community and in saying they lied about the cause of death. These results imply that those bereaved through suicide apparently receive less community support than survivors of accidents and other types of death.