Young Cancer Patients Research Articles

The risk of peripartum cardiomyopathy among pediatric, adolescent, and young adult cancer patients exposed to doxorubicin: an opinion article

The risk of peripartum cardiomyopathy among pediatric, adolescent, and young adult cancer patients exposed to doxorubicin: an opinion article

Impact of best practice advisory on genetic counseling referrals for young endometrial cancer patients

Impact of best practice advisory on genetic counseling referrals for young endometrial cancer patients

Unveiling the heartbeat of hope: exploring cardiovascular morbidity, mortality, and socioeconomic threads in 65,173 Child, Adolescent, and Young Adult (caya) cancer patients

Abstract Background Despite significant progress in managing cancer in children, adolescents, and young adults (CAYAs), persistent complications impact their quality of life with some being severe or life-threatening.(1,2) Long-term outcomes depend on common risk factors for malignancy and cardiovascular diseases (CVD) that overlap, and treatments are known to increase the risk for CVD. (3,4) Healthcare inequality due to socioeconomic status is omnipresent and may significantly impact outcomes. Purpose This study aims to comprehensively cover morbidity, mortality, demographic, and socioeconomic factors among CAYAs and investigate their impact on cardiovascular outcomes. Methods This retrospective matched cohort study included the entire Swedish population under 25 with cancer from 1958 to 2021. The study population was identified from the National Board of Health and Welfare's Cancer Register, with controls paired 1:5 based on age, sex, and residence. Multiple registers provided data on morbidity, mortality, and demographics. Results Covering 63 years, identified 65,173 CAYAs (1.24 million patient-years) and matched with 312,935 controls (7.45 million person-years), a total of 378,108 individuals (74% females). The mean follow-up was 19.5 (SD16.9) years for CAYAs, and 23.8 (16.8) for controls, (p<0.001). At the end of the study, the median age of CAYAs was 33.4 (IQR 27.9) years and controls 39.2 (28.3) (p<0.0001), with an age span of <1-88 years in both groups. CVD was detected in 16.9 % of the CAYAs, representing a 1.21-time elevated risk (95% CI 1.18-1.23, p<0.0001) compared to controls. CAYAs had a higher mortality rate, and 5-years survivors lived a mean of 26.9 years shorter than controls. CV mortality was also increased in CAYAs, (1.9% compared to 0.7% in controls) but at a higher age, although at a mean of 22.8 years younger than their controls. The 5-year survivors were older at CV mortality and lived in mean 6.5 years shorter than controls (p<0.0001). After adjusting for socioeconomic factors, individuals born outside Europe and those with greater sick leave had a higher mortality risk, while education and marriage showed a beneficial association with mortality. (p<0.0001). Interpretation The Rebuc study, spanning six decades, revealed a significantly increased risk of serious complications among young cancer patients in Sweden. Not only do young cancer patient survivors face a significantly higher risk for cardiovascular disease, but the higher mortality risk before middle age also underscores the severity of the health challenges they confront. Furthermore, these young individuals are more susceptible to socioeconomic factors that may adversely affect their survival.

Oncofertility in primary health care: the role of the Portuguese family doctor

Abstract Background The increasing number of cancer cases diagnosed at young ages and the impact of the disease and treatments on reproductive function have led to the development of Oncofertility. While oncologists typically lead these discussions, family doctors, as primary care providers, also play a crucial role. This study aims to assess family doctors’ knowledge, attitudes, and practices regarding fertility preservation in cancer patients. Methods This cross-sectional study, conducted between April 2023 and March 2024, surveyed 351 General and Family Medicine doctors from the Portuguese Northern Regional Health Administration. The questionnaire, consisting of 15 questions, assessed sociodemographic profiles, knowledge, attitudes, and practices. Data were analyzed using descriptive statistics and multivariate logistic regression. Results Most participants were female (80.5%) and under 40 years old. The majority (91.5%) had treated fewer than 10 cancer patients under 40 in the past two years. Key barriers included lack of knowledge (63.3%), time constraints (57.0%), and patient age (18.5%). Male physicians were more likely to address specific fertility concerns (OR 2.239) and less likely to view patient age as a barrier (OR 0.459). Physicians aged 31-35 were less likely to discuss fertility preservation (OR 0.553) but more likely to address it in the first consultation (OR 2.969). Urban-based physicians were less likely to discuss fertility preservation (OR 2.099). Only 9.1% always discussed fertility preservation before treatment, 27.6% did so sometimes, and 63.3% never discussed it. Conclusions There are significant gaps in the knowledge and practices of family doctors regarding fertility preservation for cancer patients. Targeted training and resources are urgently needed to support family doctors in effectively discussing fertility preservation, crucial for improving the quality of life of young cancer patients wishing to preserve their fertility. Key messages • Empowering Portuguese family doctors to address fertility concerns in cancer patients contributes to comprehensive oncofertility care, improving patient outcomes and quality of life. • Integrating oncofertility support with Portuguese family doctors strengthens primary care, ensuring discussion of fertility preservation is considered as part of cancer treatment planning.

Identifying central dimensions of quality of life including life-related values, preferences and functional health in older patients with cancer: a scoping review protocol.

Older patients with cancer already represent the largest proportion of cancer survivors which will further increase in the upcoming years. However, older patients are highly underrepresented in clinical research, leading to a detrimental knowledge gap. Research on important aspects of quality of life (QoL) and associated factors for older patients with cancer is insufficient to date. The objective of this scoping review therefore is to investigate the dimensions of QoL including functional health, life-relevant values and preferences in older adults with cancer across all tumor entities and health care settings. It will further identify medical, sociodemographic, psychosocial and geriatric aspects associated with QoL in the elderly and compare these with younger cancer patients and older non-cancer cases. Published articles investigating QoL dimensions and associated factors in older patients with cancer, i.e., exclusively patients ≥65 years or mean/median age ≥ 70 years for age-mixed samples, or that compare results of older with younger cancer patients or with older non-cancer cases will be considered for this scoping review. Older patients with cancer across all tumor entities, disease stages and health care setting will be included. PubMed and PsychINFO databases will be searched for relevant articles. Abstracts and titles will be screened for basic inclusion, and two independent reviewers will conduct a full text screening to evaluate the age criteria and decide on the final inclusion of the study. Data on study and participant characteristics, QoL dimensions and geriatric factors will be extracted using a data extraction sheet. Results will be summarized descriptively to address the objectives of this review. The findings of this scoping review will provide valuable insights into central dimensions of QoL, including values, preferences and functional health in older adults with cancer, and help to improve targeted interventions and healthcare planning.

Characteristics and influencing factors of posttraumatic growth in young and middle-aged cancer patients: A cross-sectional latent profile analysis.

This cross-sectional study aimed to examine the subgroups of posttraumatic growth (PTG) among young and middle-aged cancer patients in China and to explore influencing factors. A total of 378 young and middle-aged cancer patients aged 18-60 were selected for the study at a hospital in Shanghai, China. Latent profile analysis identified four categories of PTG among young and middle-aged cancer patients: the "predicament group" (5.9%), the "struggle group" (36.8%), the "limited growth group" (44.1%) and the "remarkable growth group" (13.2%). Age, gender, time since diagnosis, cancer site, primary/recurrence, and meaning in life significantly influenced the distribution of PTG in young and middle-aged cancer patients. Targeted interventions should be developed to enhance the level of PTG among this population, considering the specific characteristics and influencing factors within each profile.

Nme8 is essential for protection against chemotherapy drug cisplatin-induced male reproductive toxicity in mice.

Cisplatin (CP), a chemotherapy drug commonly used in cancers treatment, causes serious reproductive toxicity. With younger cancer patients and increasing survival rates, it is important to preserve their reproductive capacity. NME8 is highly expressed in testis and contains thioredoxin and NDPK domains, suggesting it may be a target against the CP-induced reproductive toxicity. We deleted exons 6-7 of the Nme8 in mice based on human mutation sites and observed impaired transcript splicing. In mice, Nme8 was not essential for spermatogenesis, possibly due to functional compensation by its paralog, Nme5. Nme8 expression was elevated and translocated to the nucleus in response to two weeks of CP treatment. Under CP treatment, Nme8 deficiency further impaired antioxidant capacity, induced lipid peroxidation and increased ROS level, and failed to activate autophagy, resulting in aggravated DNA damage in testes and sperm. Consequently, the proliferation and differentiation of spermatogonia and the meiosis of spermatocyte were almost completely halted, and sperm motility was impaired. Our research indicates that NME8 protects against CP-induced testis and sperm damage. This may provide new insights into the physiological functions of the Nme family and potential targets for preserving fertility in young male cancer patients.

Health-related quality of life of toddlers during and after cancer treatment

BackgroundThere is a knowledge gap regarding health-related quality of life (HRQOL) in childhood cancer patients below 2 years of age. The aim of this study was therefore to compare HRQOL of young children during and after treatment for cancer, to healthy controls, and to investigate effects of biopsychosocial factors. ProcedureThe study is based on data from an online monitoring program. Parent-proxy reports of HRQOL in 205 children aged 12–24 months were compared to 108 healthy children. The parents filled out the TNO-AZL Preschool Quality of Life questionnaire for young children, which consists of 12 subscales, in addition to a parental distress thermometer. ResultsParticipants undergoing treatment had less favorable HRQOL than children after treatment for eight of the subscales. They also had less favorable HRQOL than healthy children for seven scales, while the only significant difference between children off treatment and healthy controls was for motor functioning. For ten subscales, there were significant relationships between biopsychosocial variables and HRQOL outcomes. Parental distress and treatment with immunotherapy were the variables most frequently associated with lower HRQOL. ConclusionsParental distress should be considered when monitoring young childhood cancer patients. Treatment with immunotherapy is likely to be a marker of disease severity and might represent other underlying factors affecting HRQOL. The association between immunotherapy and HRQOL therefore needs more research. While there was a significant difference depending on treatment status, it cannot be concluded that this represents an improvement in HRQOL after end of treatment.

Effectiveness of meaning in life intervention programme in young and middle-aged cancer patients: study protocol for a randomised controlled trial

IntroductionDiminished levels of meaning in life can have a range of detrimental effects on cancer patients, including heightened anxiety, depression, psychological distress, reduced quality of life and, in severe cases,...

P30-2 A scoping review on prevalence of anxiety and depression (AnD) in adolescent and young adult cancer (AYAO) patients

P30-2 A scoping review on prevalence of anxiety and depression (AnD) in adolescent and young adult cancer (AYAO) patients

EP.01A.01 Role of Diet and Exercise in Young Lung Cancer Patients with Driver Mutations (NCT04640259)

EP.01A.01 Role of Diet and Exercise in Young Lung Cancer Patients with Driver Mutations (NCT04640259)

Experiences and Comfort of Young Cancer Patients Discussing Cannabis with Their Providers: Insights from a Survey at an NCI-Designated Cancer Center.

Cannabis use among cancer patients for managing treatment-related symptoms is increasing, yet little is known about patterns in patient-provider communication. This study examines demographic differences in cannabis use communication at a National Cancer Institute-designated cancer center. The analysis included cancer patients aged ≥ 18years who self-reported current cannabis use (past 30days) and had visited Sylvester Comprehensive Cancer Center within the past 5years (N = 226). Data were collected via an anonymous electronic survey on REDCap. Responses on patients' disclosure of cannabis use to cancer doctor/care team and their comfort in discussing cannabis were analyzed. Chi-squared/Fisher's exact tests and t-tests were applied. Logistic regression estimated the associations between age and stage of cancer treatment with patients' comfort in discussing cannabis use with cancer doctor (oncologist). The sample was 51.8% male and 39.4% Hispanic (mean age, 45.9years (SD = 15.1)); 41.1% were aged 20-39years, 43.8% were undergoing treatment, and 35.4% were in follow-up/had finished treatment. Over half (50.4%) did not disclose cannabis use to their cancer doctor/care team. Non-disclosers were more often younger (20-39years) than disclosers (52.6% vs. 29.5%, p < 0.01). Most patients (72.5%) felt comfortable discussing cannabis use with their oncologist; however, younger patients (20-39years) were more often uncomfortable (40.8%). Logistic regression showed newly diagnosed patients had lower odds (aOR, 0.41; 95% CI, 0.12-0.98) of comfort discussing cannabis compared to those in follow-up/finished treatment. Younger patients (20-39years) also had lower odds (aOR, 0.11; 95% CI, 0.03-0.40) of feeling comfortable discussing cannabis compared to older patients (≥ 60years). Age and treatment stage significantly impact the cannabis use disclosure and comfort in discussing it with cancer doctor/care team. These findings underscore the importance of considering age-related factors and treatment status when addressing cannabis use discussions within oncology setting.

Determinants of the implementation of eHealth-based long-term follow-up care for young cancer survivors: a qualitative study

BackgroundeHealth may help closing gaps in the long-term follow-up care of former young age cancer patients. While its introduction to medical aftercare appears promising, it also faces obstacles in the course of its implementation. This study explored what prospective eHealth applications have to achieve and what facilitating and hindering factors are associated with the implementation of them.MethodsA qualitative, explorative-descriptive design involving semi-structured interviews was used in this study. General practitioners (GPs) from urban and rural areas as well as former cancer patients were recruited and interviewed. The interview guide focused on expectations of telemedical care services for the patient group of children and adolescents as well as potential facilitating and hindering factors of the implementation of telemedical care services for former cancer patients. Interviews were recorded, transcribed and analyzed on the basis of qualitative content analysis as described by Kuckartz.ResultsEmpiric saturation was reached after 25 interviews, respectively. The age of the physicians surveyed at the time of the interviews ranged from 27 to 71 years, with an average of 42 years. The former patients ranged in age from 21 to 43 at the time of participation, with an average age of 34. The age at diagnosis ranged from 3 to 31 years. eHealth services were considered an effective way to maintain continuity of care and improve the health literacy of cancer survivors. Cooperation with health insurance companies and gamification-elements were regarded as beneficial for the introduction of eHealth structures. Poor interface compatibility, insufficient network coverage and lack of digital literacy were valued as potential barriers.ConclusionsIf properly introduced, eHealth shows the potential to provide stakeholders with tools that increase their self-efficacy and ability to act. As the technology continues to advance, our data provides application-oriented factors for tailored implementation strategies to bring eHealth into the field.

University of North Carolina adolescent and young adult cancer program: reach and characteristics of care.

Cancer care organizations often struggle to adequately address the unique needs of adolescent and young adult cancer patients, resulting in poorer outcomes compared with other age groups. Creation of adolescent and young adult cancer programs serves to bridge this gap and improve quality of care for this population. We aimed to describe the evolution and impact of the University of North Carolina at Chapel Hill's Adolescent and Young Adult Cancer Program. To do so, we conducted a retrospective cohort study utilizing electronic health record data matched with North Carolina Cancer Registry data from 2014 to 2022. Between 2014 and 2022, a total of 4016 adolescents and young adults (aged 13-39 years) received cancer care at the University of North Carolina Medical Center, with 670 having contact with the Adolescent and Young Adult Cancer Program. Program-contacted patients were younger, more likely to be non-Hispanic Black race, and more likely to have metastatic disease or hematologic malignancies. We saw a steady increase in patient volume over the study period, corresponding with program growth.

Knowledge, attitudes, and practices of healthcare providers among women oncofertility in Iran: a cross-sectional study

BackgroundIn recent years, Iran has witnessed a remarkable increase in the incidence of cancer. This has led to an emerging challenge in the field of oncofertility, which seeks to address the impact of cancer treatments on fertility and endeavors to preserve reproduction. The study assessed healthcare providers’ awareness, attitudes, and practices regarding fertility preservation (FP) in Iran.MethodsA cross-sectional study was conducted to assess healthcare providers’ knowledge, attitudes, and practices regarding oncofertility. An online self-made oncofertility survey of twenty-four items was administered to randomly selected participants from a list of healthcare providers registered with the Medical Council. The data were collected anonymously via Google Forms. Descriptive statistics, including number (n), prevalence (%), mean, and standard deviation, were calculated using SPSS 26.0. Additionally, chi-square tests were used to examine associations between categorical variables. Participants were categorized into oncology, obstetrics and gynecology (OB/GYN), and other specialties.ResultsA total of 423 responses were received and analyzed. Approximately 60% of the participants were obstetrics and gynecology subspecialists, while the remaining participants represented various disciplines such as surgery (9.7%), radiotherapy (6.4%), nuclear medicine (5.2%), and pediatrics (1.4%). More than 30% of the participants had not received any specific education about oncofertility, and more than 20% stated that FP strategies are not part of their routine treatment plan for young cancer patients. Oncologists had more education than those in the Obstetrics & Gynecology group. Half the participants were unaware of insurance coverage, and FP options were infrequently recommended.ConclusionsThese findings highlight the urgent need to enhance healthcare workers’ knowledge and attitudes toward FP in Iran and enable them to provide comprehensive support and guidance to cancer patients.

Character Strength-Based Cognitive-Behavioral Therapy Focusing on Adolescent and Young Adult Cancer Patients with Distress: A Randomized Control Trial of Positive Psychology

Character Strength-Based Cognitive-Behavioral Therapy Focusing on Adolescent and Young Adult Cancer Patients with Distress: A Randomized Control Trial of Positive Psychology

Distant metastatic patterns in young and old non-small cell lung cancer patients: A dose‒response analysis based on SEER population

BackgroundFew research has explored the risk of distant metastasis dynamically changes with age in non-small cell lung cancer patients. The objective of this study was to explore the risk factors of developing distant metastasis with changing age. MethodsThis retrospective cohort study was based on a large population of patients with non-small cell lung cancer from the SEER database. Logistic regression was applied to identify risk factors for distant metastasis. The clinicopathological features were compared between the young group (≤50 years old) and the old group (>50 years old). Dose-response analyses were conducted to explore risk of distant metastasis changes with age. ResultsA total of 18,711 patients were studied in this study. According to the univariate and multivariate logistic regression analyses, ten factors were found to be risk factors for distant metastasis. Young patients have a greater incidence of each pattern of metastasis. However, the survival time of younger patients was longer. Dose-response analyses indicated that the risks of pleural or pericardial metastasis and overall distant metastasis gradually decreased with age at younger ages, but they intend to increase at older ages. ConclusionsAge, sex, ethnicity, histology, T category, N category, differentiation grade, primary site of the tumor, ipsilateral metastases are factors associated with distant metastasis in NSCLC patients. Young patients have a greater risk of distant metastasis. The distant metastasis may decrease with the increasing age in patients younger than 70 years, but increase with the climb of age for patients older than 70 years.

Transformation Through Practice: A Dialogical Exploration of Embodiment and Presence in Arts-Based Qualitative Research With Self and Others

In this article, we discuss the potential of artist-researchers inviting research participants to engage directly in arts- and practice-based ethnographic work. To enable openings for this engagement, we find that the artist-researcher ontologically must stay oneself but also be able to share the self so that embodied knowing and years of embedded repertoires may find pathways of externalization, which may be walked co-creatively with research participants. In a reflexive conversation, we—Pini (dance artist, anthropologist) and Høybye (collaborative songwriter, ethnographer)—share insights from our respective artistic and academic fields to discern which areas of practice and knowledge creation may be similar, and which may be different. The aim is to identify how ways of working that have been transformative for us may be facilitated in interventions for others, and more specifically young cancer patients in our joint ongoing research project.

Current status and factors influencing the work readiness of middle-aged and young postoperative lung cancer patients.

To identify the current status of return-to-work readiness and analyze its influencing factors among middle-aged and young postoperative lung cancer patients. From July 2022 to February 2023, a total of 144 middle-aged and young postoperative lung cancer patients who had been treated in the Department of Thoracic Surgery of West China Hospital, Sichuan University and had not returned to work were selected as the research subjects. A general information questionnaire, the Readiness for Return-To-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), and the Simplified Coping Style Questionnaire (SCSQ) were used for the survey. Univariate analysis and ordinal logistic regression analysis were used to assess the current status of work readiness and its influencing factors. The distribution of work readiness from high to low was as follows: behavioral preparation-self-assessment stage, intention stage, preintention stage, and behavioral preparation-action stage. Univariate analysis showed that age, place of residence, occupation, nature of work, average family income, scope of surgery, postoperative complications, surgical site, and primary coping strategies were statistically significant (P < .05). The ordinal logistic regression analysis revealed that patients engaged in mentally oriented work (odds ratio [OR] = 13.78, P < .001), with a monthly family income of ≥ 10,000¥ (OR = 6.28, P = .017), proactive coping strategies (OR = 4.84, P = .019), and higher self-efficacy (OR = 1.17, P < .001) had higher work readiness. Patients engaged in other industries (OR = 0.25, P = .028), agricultural, forestry, and fishing labor (OR = 0.08, P < .001), unemployed (OR = 0.12, P = .038), and with a monthly family income of < 1000¥ (OR = 0.07, P = .026) had lower work readiness. In overall, this study suggests that the work readiness of postoperative lung cancer patients needs improvement. Occupation, nature of work, average family income, primary coping strategies, and general self-efficacy are associated with return-to-work readiness among middle-aged and young postoperative lung cancer patients.

The role of the mental health nurse in pediatric hematology-oncology - Part 1: Developing an innovative practice.

Pediatric hematological and oncological illnesses present many coping challenges. Mental health issues can arise during and after treatment, in both patients and their families. The current model of care does not always seem to meet the needs identified by some young patients. In Quebec, nurses are allowed to assess and care for patients experiencing physical and mental health difficulties (Ordre des infirmières et infirmiers du Québec, 2016). Therefore, a mental health nurse clinician (MHNC) with experience in pediatric hematology/oncology could provide care that is complementary to that offered by psychologists, social workers, and other psychosocial professionals in the pediatric hematology/oncology unit in order to meet any needs that remain unmet. The MHNC project has three stages: (1) role development, (2) role implementation, and (3) role assessment one year after implementation. In this first article, we explain how the MHNC role was developed. We used the participatory, evidence-based, patient-focused process for advanced practice nursing (APN) role development, implementation, and evaluation (PEPPA Framework; Bryant-Lukosius & Dicenso, 2004) to develop this model. The first five steps in the PEPPA Framework were applied in the creation of the MHNC role to (1) select the target population, (2) identify the stakeholders to be involved, (3) ascertain needs, (4) determine and prioritize problems and set goals, and (5) define a new model of care. After multiple meetings involving numerous health professionals and managers, the MHNC role was developed with a versatile, transdisciplinary perspective to address better the needs of young cancer patients (especially those in their teens) and their families. The role was developed around four main areas of practice: (1) interventions offered to patient-family, (2) interventions offered to health professionals, (3) psychiatric consultation-liaison, and (4) education and research. The next steps are to use a strategic plan to implement the role and then to evaluate the impact of the role one year after implementation.