Young Survivors Research Articles

Cognitive Frailty for Young Breast Cancer Survivors After Chemotherapy: Implication for the Design of Health Education Materials

Background: As the most common cancer among women globally, breast cancer often leads to accelerated frailty in younger survivors, particularly during chemotherapy, causing cognitive impairments. This highlights the urgent need for tailored health education materials to address these challenges. Objective: To analyze cognitive load in young breast cancer survivors (YBCSs) after chemotherapy and contribute to the development of more tailored and effective health education materials for this population. Methods: Cognitive load theory informed a semistructured interview guide to investigate the challenges YBCSs face when engaging with health education materials. Results: Eleven participants aged 18–45 years were interviewed. Based on cognitive load theory, 4 themes were identified as follows: symptom burden, impairment of working memory, decrease the intrinsic cognitive load, and decrease the extraneous cognitive load. Conclusions: YBCSs frequently experience cognitive burden due to chemotherapy and perimenopause, which can trigger adverse personal states that lead to working memory overload and depletion. They prefer health education materials that offer credible, relevant information presented in modern formats, particularly short videos lasting around 10 seconds. However, excessive transient information and interactive elements may create unnecessary cognitive load. Implications for Practice: Developing health education materials should focus on conciseness, visual appeal, and small, digestible segments to ease cognitive load. Incorporating storytelling and relatable scenarios can significantly boost engagement and comprehension. What is Foundational: This model, informed by cognitive load theory, could be used as the basis of educational materials of greater care usefulness for these younger survivors of breast cancer.

Abstract TP130: Identifying Facilitators and Barriers to Positive Illness Perceptions in Younger Stroke Survivors during Acute Hospitalization

Background: Despite increasing stroke incidence in US adults younger than 44 years, little is known about their illness perceptions, which have been shown to impact stroke recovery and possibly secondary prevention. This study’s objective is to identify facilitators and barriers to positive illness perception of stroke survivors and their caregivers during acute hospitalization. Methods: Stroke survivors and caregivers participated in virtual focus group sessions with structured interview guides assessing perceptions of hospitalization and general wellbeing. Sessions were recorded and transcribed using NVivo software. Framework method was used for analysis; three independent coders developed a comprehensive codebook from transcripts. Framework matrices were used to identify recurrent themes, which were then determined to be facilitators or barriers to positive illness perception during acute hospitalization. Results: Stroke survivors and caregivers (n=12) participated in seven focus group sessions. Younger survivors (n=4; 3 male, 1 female survivors) were aged 25 to 44, compared with older survivors (n=8; 3 female survivors, 5 female caregivers) aged 45 to 84. Across each phase of acute hospitalization, five themes related to illness perceptions emerged: (1) symptom recognition and health system navigation; (2) communication of diagnosis and management; (3) presence of a champion; (4) clinician bias; (5) psychological distress. Figure 1 shows how stroke survivors, based on their age, experienced the acute hospitalization and how illness perception was shaped by these themes. Clinician bias, psychological distress, and the inability to recognize stroke symptoms emerged as unique barriers for younger stroke survivors. Conclusion: Despite a similar diagnosis, illness perceptions of younger stroke survivors were distinct compared to older counterparts. Younger survivors experienced bias and psychological distress, exposing differential treatment in care. A facilitator to positive illness perception among both populations was the presence of a champion; in younger survivors, advocacy of a partner was crucial for diagnosis, suggesting the importance of symptom recognition in younger populations. Future studies are required to explore the transferability of our findings and to investigate clinician recognition of stroke in younger populations.

Abstract WP126: Identifying Characteristics Associated with Development of Posttraumatic Stress Disorder in Young Adult Stroke Survivors

Abstract WP126: Identifying Characteristics Associated with Development of Posttraumatic Stress Disorder in Young Adult Stroke Survivors

The successes experienced by collegiate athlete cancer survivors.

As awareness increases related to young athletes diagnosed with cancer, it is essential to gain deeper insight into their backgrounds, experiences, and unique goals to effectively offer personalized care. Therefore, the purpose of this study was to explore the lived experiences of collegiate athletes in the USA diagnosed with cancer, reflecting on their academic and athletic successes during their cancer experiences. A phenomenological design to study the nature and states of lived experiences in collegiate athlete cancer survivors diagnosed with cancer between the ages of 10 and 39years old was implemented for this study. Eighteen collegiate athlete cancer survivors (78% female and 22% male) participated in semi-structured interviews. The interviews were audio and video recorded using the Zoom videoconferencing software. The mean age at the time of the enrollment was 22.3 ± 1.6years. Seventeen participants (94%) identified as white/Caucasian. Five themes related to successes emerged from the thematic analysis: (1) academic successes, including academic accommodations, renewed determination; (2) athletic successes, including return to play, physical fitness/health; (3) athletic identity, including athletic mindset, body awareness, recovery advantages; (4) post-cancer growth, including renewed sense of purpose, new appreciation for life/sport, spiritual growth, finding silver linings, personal strength and personal growth, new possibilities, positive changes in relationships; and (5) support successes, including medical support, community support, college/university support, spiritual/religious support, financial/insurance support, athletic support. As research on young cancer survivors continues to increase, there is a pressing need to investigate their lived experiences. The findings from this study and the emerging themes carry significance to the cancer community. Further investigation is imperative, especially concerning the impact of cancer on collegiate athletes.

Effect of Physical Activity on Physical and Mental Health in Young Cancer Patients and Survivors: A Systematic Review of RCTs and CCTs

Introduction Young cancer patients (YCP) face high risks of acute and long-term physical and mental health effects resulting from their malignancy and its treatment (Benzing et al., 2022; Siegwart et al., 2020). Physical activity (PA) is increasingly recognized as a strategy to address physical, mental, cognitive, and social challenges faced by YCP and survivors (Braam et al., 2016). This systematic review aimed to summarize findings from randomized controlled trials (RCTs) and clinical control trials (CCTs) evaluating the impact of PA interventions on physical and mental health outcomes in YCP and survivors. Methods A systematic search was conducted in APA PsycINFO, PubMed, SPORTDiscus, Web of Science, Embase, and Scopus. We examined RCTs and CCTs investigating PA interventions in children and adolescents with cancer, during or after treatment, that reported outcomes related to physical or mental health and/or quality of life. Two authors independently screened studies for inclusion, extracted data, and assessed the risk of bias. Results Of 1,164 articles screened, 32 RCTs and CCTs met eligibility criteria, involving 1,315 participants aged 4–19 years. Studies included inpatients (18), survivors (11), or both (2). Chronic PA interventions, such as aerobic, resistance, or combined motor-cognitive training, were implemented. All studies reported physical health outcomes, primarily focusing on cardiorespiratory fitness, muscle strength, and fatigue, while 18 studies assessed psychological outcomes, including depression and quality of life. Four studies objectively evaluated cognitive functions. Benefits were most frequently observed (>50%) for strength, fatigue, and self-efficacy, with no negative effects reported. Discussion/Conclusion Despite variability in session durations and intervention lengths, this review highlights the broad benefits of PA for YCP and survivors, with no indication of negative effects. Most studies have focused on physical and mental health outcomes (Braam et al., 2016), with limited attention to cognitive performance and motor ability, despite the high risk of cognitive late effects in this population (Krull et al., 2018). High-quality RCTs are needed to better understand the role of PA in motor and cognitive development among YCP and survivors. References Benzing, V., Siegwart, V., Spitzhüttl, J., Schmid, J., Grotzer, M., Roebers, C. M., Steinlin, M., Leibundgut, K., Everts, R., & Schmidt, M. (2021). Motor ability, physical self‐concept and health‐related quality of life in pediatric cancer survivors. Cancer Medicine, 10, 1860–1871. https://doi.org/10.1002/cam4.3750 Braam, K. I., van der Torre, P., Takken, T., Veening, M. A., van Dulmen‐den Broeder, E., & Kaspers, G. J. L. (2016). Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database of Systematic Reviews, 3, CD008796. https://doi.org/10.1002/14651858.CD008796.pub3 Krull, K. R., Hardy, K. K., Kahalley, L. S., Schuitema, I., & Kesler, S. R. (2018). Neurocognitive outcomes and interventions in long-term survivors of childhood cancer. Journal of Clinical Oncology, 36(21), 2181-2189. https://doi.org/10.1200/jco.2017.76.4696 Siegwart, V., Benzing, V., Spitzhuettl, J., Schmidt, M., Grotzer, M., Steinlin, M., Leibundgut, K., Roebers, C., & Everts, R. (2020). Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors. Neuropsychological Rehabilitation, 32 (6), 922–945. https://doi.org/10.1080/09602011.2020.1844243

Listening to young Asian sexual violence survivors’ voices through found poetry

ABSTRACT This paper explores found poetry as a method for listening to the voices of young Asian survivors. The survivors referenced in this paper were participants in the study, Young Asian Sexual Violence Survivors’ Experiences and Expectations of Support Systems Within New Zealand Schools. By integrating participants’ words into found poems, this study provides an authentic platform for participants’ stories. The poems emphasise the intersection of cultural expectations, generational divides, and the unique challenges faced by young survivors in seeking support. Through this approach, the research highlights the emotional weight and resilience embedded in these narratives. While found poetry powerfully conveys the emotional and experiential aspects of the data, it also raises challenges, such as the risk of generalisation and the potential omission of certain themes. Nevertheless, this method serves as a vital tool in amplifying marginalised voices, ensuring that the young survivors’ experiences are not only heard but deeply understood.

Needs Assessment to Guide the Development of a Pediatric Survivorship Program to Promote the Physical and Psychological Well-being of Children After Cancer Treatment.

Studies have provided insights into the major challenges and needs of young children who survive cancer. Many such challenges are related to a lack of support during the patient's transition back to normal life. Survivorship programs are designed to help survivors cope with potential late effects of treatment and to provide psychosocial support. However, there is not yet a survivorship program in Hong Kong that provides young survivors with continuous care. To explore the challenges and needs faced by pediatric cancer survivors during their transition from patient to survivor and to guide the development of the survivorship program. A qualitative descriptive design utilizing purposive sampling was used. Semistructured interviews were conducted with 30 pediatric cancer survivors aged between 9 and 18 years, along with their parents/caregivers, as well as 5 pediatric cancer oncology nurses and 3 pediatric oncologists. The interviews yielded 4 overarching themes: (1) challenges in school reintegration, (2) concerns relating to physical and psychological well-being, (3) lack of social support and adaptation difficulties, and (4) needs for supportive care services. The findings provide insights into the needs of pediatric cancer survivors, their parents, and other key stakeholders. These insights suggest that a pediatric cancer survivorship program should be established in Hong Kong as an essential component of the continuum of cancer care. Survivor clinic care should be enhanced to provide continuous support for children who have completed medical treatment and their caregivers, incorporating the perspectives of all stakeholders.

Development and validation of a dynamic nomogram to predict alexithymia in young and middle aged stroke patients

Alexithymia, characterized by difficulty in expressing and recognizing emotions, is prevalent among young and middle-aged stroke survivors and can significantly impact rehabilitation outcomes. This study aims to develop and validate a dynamic nomogram to predict the risk of alexithymia in this population. This cross-sectional study was conducted from November 2022 to August 2023 at two tertiary hospitals in Jinzhou City and Cangzhou City, enrolling 319 patients. Predictive factors for alexithymia, such as Activities of Daily Living (ADL) scores, social support levels, lesion location, educational background, and National Institutes of Health Stroke Scale (NIHSS) scores, were identified through univariate and multivariate analyses. These factors were integrated into a web-based dynamic nomogram. The model’s accuracy was evaluated using Receiver Operating Characteristic (ROC) curves and 1000 bootstrap resamples. In the training cohort, 47.8% of patients were diagnosed with alexithymia. The nomogram demonstrated excellent fit and reliability, with an Area Under the Curve (AUC) of 0.837 (95% CI: 0.787–0.889) in the training cohort and 0.847 (95% CI: 0.767–0.928) in the validation cohort, enabling reliable early detection of alexithymia. The dynamic nomogram provides healthcare professionals with an important tool for early detection and management of alexithymia in young and middle-aged stroke survivors. While the model shows high predictive accuracy, its applicability may be limited to similar clinical settings. Future studies should evaluate its utility across diverse healthcare systems. This tool has the potential to significantly improve rehabilitation outcomes by supporting personalized therapeutic strategies and interventions.

Digital humanistic program to manage premature frailty in young breast cancer survivors with gender perspective

Premature frailty is a critical challenge for young breast cancer survivors (YBCSs), impacting their health and perpetuating gender inequality through heightened vulnerability and marginalization. While digital health shows promise in frailty screening, its effectiveness for comprehensively managing frailty remains inconclusive. This randomized controlled trial, registered at the Chinese Clinical Trial Registry (ChiCTR2200058823), tests the “AI-TA” program’s efficacy on premature frailty and quality of life in YBCSs. The intervention group received a gender- and generation-sensitive program combining artificial intelligence interactions and humanities skills. The control group received 12 weeks of online information support. Both groups improved in frailty dimensions (P < 0.05); the intervention group showed notable enhancements in psychological (P = 0.013) and social frailty (P < 0.001). Quality of life also improved more in the intervention group from T1 to T2 (β = 15.384, 95% CI:13.028–17.740, P < 0.001). Results show a gender- and generation-sensitive digital humanistic program can optimize frailty management, promoting survivorship and gender equity.

Reconfiguring Priorities: Breastfeeding Decision-making Among Young Breast Cancer Survivors.

Breast cancer survivors face unique challenges in breastfeeding decisions. Limited research exists on the experiences and decision-making processes of young women with breast cancer regarding breastfeeding. To explain the decision-making processes of young women with breast cancer in relation to breastfeeding throughout the cancer trajectory. A constructivist grounded theory approach was used. Semistructured interviews were conducted with 12 women diagnosed with breast cancer and 8 healthcare professionals. Data were analyzed using constant comparative analysis. The core category "Reconfiguring Priorities: The Secondary Role of Breastfeeding in the Context of Breast Cancer in Young Women" emerged, encompassing 3 subcategories: (1) scars over time, (2) omitting breastfeeding in oncological care, and (3) self-management of breastfeeding. Breastfeeding decision-making among young breast cancer survivors is not driven by conscious will but by a constant struggle with the conditioning factors of the oncological process: mortality and toxicity of drugs to breast milk. The lack of professional support leads women to develop their own strategies for managing breastfeeding, marked by ambivalence between motivations and personal challenges. Healthcare professionals should integrate breastfeeding discussions into oncological care for young breast cancer survivors. Specialized lactation consultants with oncology expertise should be incorporated into the care team. Peer support programs can provide valuable guidance based on lived experiences, empowering women to make informed decisions about breastfeeding after breast cancer.

Increased Prevalence of Coronary Atherosclerosis in Cancer Survivors: A Retrospective Matched Cross-sectional Study with Coronary CT Angiography.

Cancer and cancer treatment may accelerate the development of cardiovascular disease. With the improved prognosis of cancer survivors, cardiovascular events are increasing in this patient group. However, it is unknown whether the prevalence of coronary atherosclerosis is increased in patients with a history of cancer. This study aims to evaluate the prevalence and severity of coronary atherosclerosis in different age groups of cancer survivors compared to matched controls. Consecutive cancer survivors aged >30 years who underwent evaluation for stable coronary artery disease with coronary computed tomography angiography (CCTA) were included in this retrospective study. Propensity score matching was performed and cancer survivors were matched 1:2 to a control population without oncological history. The presence of coronary atherosclerosis was assessed in both groups. The study population consisted of 312 cancer survivors and 624 matched controls. Median age at CCTA scan was 59.2 [50.3-67.5] years and 66.0% was female. Coronary atherosclerosis was observed in 257 (82.4%) cancer survivors compared to 459 (73.6%) control patients with an Odds Ratio (OR) of 1.68 [95% CI: 1.19-2.36], p=0.003. Mainly younger cancer survivors aged between 30-59 years had an increased prevalence of coronary atherosclerosis with an OR of 2.21 [95% CI: 1.40-3.49] compared to control patients (p=0.001). In addition, thoracic radiotherapy showed a significant association with increased prevalence of atherosclerosis in the younger population with an OR of 3.29 ([95% CI: 1.70-6.38], p<0.001). Patients with a history cancer have an increased prevalence of coronary atherosclerosis on CCTA compared to matched patients without cancer. This effect was most pronounced in younger patients aged 30-59 years.

Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity

BACKGROUND Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors. AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes. METHODS A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used. RESULTS A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P &lt; 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P &lt; 0.05). CONCLUSION The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.

Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity.

Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors. To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes. A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used. A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P < 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P < 0.05). The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.

Exploring Quantum Touch Therapy's Efficacy in Managing Stress Among Young Stroke Survivors: A Quasi-Experimental Approach

Stroke is a neurological disorder that can lead to disability and significant stress, particularly among young stroke survivors. Quantum Touch therapy, an alternative energy-based therapy, may hold potential for stress management. Evaluate the effectiveness of Quantum Touch therapy in reducing stress levels among young stroke survivors. This quasi-experimental study used purposive sampling, involving 76 young stroke survivors (aged 18-50), who were randomly assigned to either the intervention group (38 participants), receiving Quantum Touch therapy, or the control group (38 participants), receiving only standard care. Therapy sessions were conducted six times per week, each lasting 30 minutes, over the study period from March 1 to May 1, 2024. Stress levels were measured using the Depression Anxiety Stress Scales-42 questionnaire before and after the intervention. Analysis showed that the intervention group experienced a significant reduction in stress levels after undergoing Quantum Touch therapy, with an average stress score change of 3.29 (p &lt; 0.001), while the control group showed no significant change (p = 1.000). The statistical analysis also highlighted a substantial effect size in the intervention group, emphasizing the quantifiable impact observed. This study suggests that Quantum Touch therapy has significant potential in reducing stress levels among young stroke survivors. The therapy contributes to stress reduction by restoring energetic balance, leading to deep relaxation and decreased anxiety and muscle tension. The findings support the inclusion of Quantum Touch therapy as a complementary approach in post-stroke rehabilitation, offering measurable benefits in stress management for young stroke survivors

A Faster Walking Speed Is Important for Improving Biomechanical Function and Walking Performance in Stroke Survivors.

This study compares joint kinematics and kinetics of young stroke survivors who walk <0.79m/s (slow) or >0.80m/s (fast) with reference to a healthy able-bodied group and provides clinical recommendations for guiding the gait rehabilitation of stroke survivors. Twenty-two young stroke survivors (18-55y) were recruited from 6 hospital sites in the United Kingdom. Stroke participants were classified by walking speed as slow (<0.79) or fast (>0.80m/s), and joint kinematics and kinetics at the pelvis, hip, knee, and ankle were measured during walking on level ground at self-selected speed. Ten walking biomechanical parameters correlated to walking speed (ρ ≥ .550). Stroke survivors in the slow group walked with significantly greater range of sagittal plane pelvic motion (P < .009), reduced range of hip adduction and abduction (P < .011), and smaller peak hip extension angle (P < .011) and hip flexion moment (P < .029) for the paretic limb. For the nonparetic limb, a significantly reduced hip flexion moment (P < .040) was observed compared with the fast group and control. We are the first to report how biomechanical function during walking is compromised in young stroke survivors classified by walking speed as slow (<0.79m/s) or fast (>0.80m/s) and propose that these biomechanical parameters be used to inform rehabilitation programs to improve walking for stroke survivors.

Adherence to Physical Activity Recommendations Among Stroke Survivors in the United States.

Physical activity is an effective modifiable behavior for preventing recurrent strokes. This study aims to determine the adherence to physical activity recommendations among stroke survivors in the United States. We further compared our findings with the adherence observed among myocardial infarction (MI) survivors and healthy adults, each assessed against distinct physical activity guidelines specific to their respective populations. We utilized data from the 2011 to 2019 Behavioral Risk Factor Surveillance System, a nationally representative survey. To establish benchmarks for stroke survivors, we referenced 3 different physical activity recommendations outlined in 2011, 2014, and 2021 American Heart Association stroke prevention guidelines. Similarly, for MI survivors and healthy adults, we used the 2011 guidelines for secondary prevention of coronary vascular diseases and the 2020 World Health Organization physical activity guidelines, respectively. Adherence to recommendations was determined by the respondents' self-reported intensity, duration, and frequency of physical activity. Multivariate logistic regression compared adherence in stroke survivors, MI survivors, and healthy adults. Among 48 222 stroke survivors in the United States, the overall adherence rates to 2011, 2014, and 2021 physical activity guidelines were 75.4%, 40.2%, and 69.2%. For independently mobile stroke survivors, the adherence rates increased to 78.1%, 42.1%, and 69.9%. Among MI survivors and healthy adults, the adherence rates were 42.7% and 72%. When 2021 recommendations were used as a benchmark, older (aged ≥65 years) stroke survivors were more likely to adhere to recommendations than younger survivors (71.9% versus 62.3%; P<0.0001). After adjusting for sociodemographic factors and comorbidities, non-Hispanic Black survivors were less likely to adhere to recommendations (adjusted odds ratio, 0.81 [95% CI, 0.7-0.94]), whereas older and higher educated stroke survivors were more likely to adhere to recommendations. Geographically, stroke belt and nonrural residents were less likely to adhere to recommendations ([63.5% versus 67.9%; P<0.0001]; [53.8% versus 58.7%; P<0.0001]). Stroke and MI survivors were less likely to adhere to the latest recommendations than healthy adults (adjusted odds ratio, 0.74 [95% CI, 0.69-0.8]; (adjusted odds ratio, 0.24 [95% CI, 0.22-0.26]). A substantial number of stroke survivors do not meet physical activity recommendations. Tailored interventions should be designed for at-risk populations, for example, non-Hispanic Black survivors and lower educated stroke survivors.

The challenges experienced by collegiate athlete cancer survivors.

The growing number of athletes diagnosed with cancer requires a better understanding of their background, experiences, and specific goals to provide personalized care. Therefore, the purpose of this study was to explore the lived experiences of collegiate athletes in the United States diagnosed with cancer, reflecting on various barriers and challenges because of their cancer diagnosis, as they relate to their athletic participation and educational experiences. This qualitative study used a phenomenological approach to study the nature and states of lived experiences in collegiate athlete cancer survivors diagnosed with cancer between the ages of 10 and 39 years old. Eighteen collegiate athlete cancer survivors (14 females and 4 males) participated in semi-structured interviews. The mean age at the time of the interviews was 22.3 ± 1.6 years. Seventeen participants (94%) identified as white/Caucasian. Five themes related to challenges emerged from the interviews: (1) academic challenges, (2) athletic challenges, (3) gaps in support, (4) side effects, and (5) mental health challenges. The mental health needs of collegiate athlete cancer survivors have been notably reported. As research on young cancer survivors increases, there is an opportunity for a deeper understanding of their lived experiences. The themes that emerged from this study are important and meaningful to increase the educational and athletic support as well as the mental and physical health of these survivors.

A program to enhance family resilience through improved family communication for young and middle-aged breast cancer survivors and their spouses: A feasibility study

A program to enhance family resilience through improved family communication for young and middle-aged breast cancer survivors and their spouses: A feasibility study

Depression risk among breast cancer survivors: a nationwide cohort study in South Korea

BackgroundDepression among breast cancer survivors is a significant concern affecting their long-term survivorship and quality of life. This study investigates the incidence of depression among breast cancer survivors and identifies associated risk factors.MethodsThis retrospective cohort study used data from the Korean National Health Insurance Service database and included 59,340 breast cancer patients without a history of depression who underwent surgery between January 1, 2010, and December 31, 2016. They were individually matched 1:2 by age with a general population without cancer (n = 99,834). The mean follow-up period was 6.4 ± 2.6 years. Sub-distribution hazard ratios (sHRs) and 95% confidence intervals (CIs) were calculated considering death as a competing risk and adjusting for sociodemographic factors and comorbidities.ResultsBreast cancer survivors with a mean (standard deviation) age of 51.5 (9.2) years had a 39% increased risk of depression compared to non-cancer controls (sHR 1.39, 95% CI 1.36–1.42). During the first year post-diagnosis, breast cancer survivors across all ages exhibited a significantly elevated risk of depression, with a sHR of 3.23 (95% CI 3.08–3.37). Notably, younger survivors had a sHR of 4.51 (95% CI 4.19–4.85), and older survivors had a sHR of 2.56 (95% CI 2.42–2.71). One year post-surgery, younger survivors (age ≤ 50 years) showed a 1.16-fold increase in depression risk (sHR 1.16, 95% CI 1.11–1.20), while older survivors (age > 50 years) showed no significant change in risk, which decreased over time. Use of anthracycline, taxane, or endocrine therapy was associated with an increased depression risk (sHR 1.17, 95% CI 1.13–1.22; sHR 1.12, 95% CI 1.07–1.16; and sHR 1.27, 95% CI 1.14–1.41, respectively), with endocrine therapy showing a 41% increased depression risk in older survivors (sHR 1.41, 95% CI 1.23–1.61).ConclusionThis study demonstrates a significant association between breast cancer and depression, with a particularly heightened risk in younger survivors within the first year post-diagnosis. Special attention is needed to meticulously screen for depressive symptoms during the early follow-up years for breast cancer survivors who are premenopausal or have undergone chemotherapy and endocrine therapy.

Mapping and comparing the quality of life outcomes in childhood and adolescent and young adult cancer survivors: an umbrella review and future directions.

A cancer diagnosis early in life can leave a legacy in terms of compromised Quality of Life (QoL). There is a lack of clarity regarding the impact on QoL according to age at diagnosis, with childhood cancer survivors (CCS) and adolescents and young adult cancer survivors (AYACS) often combined. As part of an EORTC Quality of Life Group study, this umbrella review aims to (1) identify the QoL outcomes reported in the literature for both CCS and AYACS, and (2) investigate the similarities and differences in QoL challenges between both groups. A systematic literature search of systematic reviews and meta-analyses was conducted in December 2023 using PubMed, PsychInfo, and CINAHL. Methodological quality was evaluated using the AMSTAR tool. Overall, 1457 articles were assessed, and 39 systematic reviews and meta-analyses met the inclusion criteria. QoL outcomes were categorized into eight QoL domains, all of which were reported in both groups of young survivors. However, reviews on CCS often focused on outcomes relating to emotional functioning, cognitive difficulties, social challenges, school functioning, body image and overall happiness, whereas AYACS reviews had a greater focus on depressive symptoms, outcomes related to sexual health and reproductive health, employment, financial difficulties, self-image and identity and the impact of cancer. This umbrella review comprehensively explores QoL outcomes among CCS and AYACS, revealing both shared and distinct challenges. Future research should focus on developing tailored questionnaires, emphasizing transition periods and incorporating a life perspective to capture unique developmental tasks of young survivors.