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Purpose: Cancer‐related fatigue (CRF) results in reduced quality of life for cancer patients. The relationship between tiredness and fatigue has been established in cancer patients and has been shown to be reciprocal, meaning the relationship is somewhat 'chicken or the egg' with tiredness influencing fatigue and vice versa. The aim of this study is to determine whether an improvement in sleep quality can ease the symptoms of CRF and whether this can support the theory that CRF symptoms stem from the effect of tiredness. Method: Three databases were searched producing 259 papers. The papers were filtered using several inclusion criteria, resulting in a final list of 20 papers for analysis. The remaining papers (20) were critically appraised using the Critical Appraisals Skills Programme (CASP) randomised control trial checklist and assessed for bias using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Results: Fourteen papers showed an increase in sleep quality that also resulted in an improvement in fatigue symptoms. Cognitive behavioural therapy was shown to be the most effective intervention with a statistically significant decrease in fatigue alongside significant improvement in sleep quality shown in six of the papers (p < 0.05). Sleep education also had a positive impact on both sleep and fatigue scores with three papers showing significant improvements. Three papers focusing on exercise interventions produced a significant improvement in fatigue symptoms and quality of sleep. Conclusion: Improving quality of sleep does ease the symptoms of CRF; however, the 'chicken or the egg' question regarding CRF and tiredness cannot be answered at this stage. [ABSTRACT FROM AUTHOR]

Background. Cancer diagnosis is a complex and multifaceted process that can be stressful and anxiety-provoking for patients. Evidence-based tools and information aids that can be used for guiding and supporting patients during cancer investigations and after diagnosis are limited. This paper presents a user-centred codesign project that aims to develop a cancer pathway support tool for patients, carers, and healthcare professionals. Method. A mixed-method codesign approach was used including prototype development (January–March 2022), three online codesign workshops (April–June 2022), one-to-one feedback, and beta testing informed by the standardised Theoretical Framework of Acceptability (TFA) questionnaire (July–October 2022). Nine individuals with lived experience of cancer contributed to the project and are referred to as codesigners. Results. The codesigners valued the potential importance of a tool that can be used by the patients and carers if they want specific information about cancer investigations, diagnosis, and treatment. The ability to select what they need as opposed to long leaflets and generating their own questions for the healthcare providers were highlighted as important aspects of improving patient care. The tool was collectively designed to provide clear definitions of the cancer care pathway and easily accessible links from trusted resources and includes practical information to minimise the burden that can be experienced from preparation for appointments and tests. Beta testing results with a small sample of potential users including patients, carers, and healthcare providers (n = 23) showed high acceptability of the guide (range = 7–35, mean = 28.52, and standard deviation = 3.88) based on the TFA questionnaire. Conclusion. A cancer pathway support tool called "Your Cancer Pathway Support Guide (YCPSG)" was developed as a result of an iterative codesign process aiming to improve patient experience and outcomes for people referred on a suspected cancer pathway or who have been diagnosed with cancer. The tool provides information and support in both digital and PDF formats. Further studies are needed to evaluate the potential impact of "Your Cancer Pathway Support Guide" on patient outcomes and experience and the wider system. [ABSTRACT FROM AUTHOR]

Objective: Non‐adherence to adjuvant endocrine therapy (AET) for breast cancer leads to increased recurrence and mortality risk and healthcare costs. Evidence on feasible, effective AET adherence interventions is scarce. This paper describes the systematic adaptation of the cost‐effective adherence improving self‐management strategy (AIMS) for patients with HIV to AET for women after breast cancer treatment. Methods: We followed the intervention mapping protocol for adapting interventions by conducting a needs assessment, reviewing target behaviours and determinants, reassessing behaviour change methods and adapting programme content. Therefore, we performed a literature review, consulted behavioural theory and organised nine advisory board meetings with patients and healthcare professionals. Results: Non‐adherence occurs frequently among AET users. Compared to HIV treatment, AET is less effective, and AET side effects are more burdensome. This drives AET treatment discontinuation. However, the key determinants of non‐adherence are largely similar to HIV treatment (e.g. motivation, self‐regulation and patient–provider relationship); therefore, most strategies in AIMS‐HIV also seem suitable for AIMS‐AET. Modifications were required, however, regarding supporting patients with coping with side effects and sustaining treatment motivation. Conclusion: AIMS seems to be a suitable framework for adherence self‐management across conditions and treatments. Intervention mapping offered a transparent, systematic approach to adapting AIMS‐HIV to AET. [ABSTRACT FROM AUTHOR]

Objective: The present systematic review and meta‐analysis aimed to analyse the effects of administered interventions on the quality of life of children with cancer in Turkey. Methods: The quantitative studies conducted with paediatric oncology patients, analysing the quality of life of Turkish children, and published papers from 2009 to 2019 were searched. Joanna Briggs Institution MAStARI Experimental and Quasi‐Experimental Research Control List and Quality Index were used for methodological assessment. Five studies comprising a total of 264 samples were included. Four studies were nonrandomised controlled trials, and one was a quasi‐experimental study. Results: Tests for heterogeneity showed that the studies, which included interventions increasing the quality of life of children with cancer, were heterogeneous. The common effect size of all studies on quality of life was determined as having a strong positive effect. Conclusions: This meta‐analysis and systematic review contribute to the knowledge of Turkish health care professionals regarding these interventions by producing results with high levels of evidence on the improvement of the quality of life among children with cancer. The present study also significantly raises awareness and encourages health care professionals to implement interventions for the improvement of quality of life among children with cancer. [ABSTRACT FROM AUTHOR]

Objective: Currently, there are no self‐management resources in Australia that support both Chinese immigrant patients affected by cancer and their caregivers. This paper reports on the development and acceptability assessment of a self‐management intervention (WeCope) in terms of its scope, social and cultural relevance and sensitivity. Methods: Using a community participatory approach in this qualitative study, patients, caregivers and community members took part in semi‐structured focus groups or interviews in Cantonese, Mandarin or English to develop and provide feedback on the acceptability of 'WeCope'. Content analysis was performed on the transcripts using inductive (codes) and deductive (themes and categories) methods. Results: Patients (n = 17), caregivers (n = 10) and community members (n = 2) participated. Four themes were developed, guided by the framework of cultural sensitivity in interventions: (1) content preference and satisfaction; (2) perceived usefulness and usability; (3) cultural relevance and acceptability; and (4) layout and presentation. Participants most commonly wanted more information about treatment‐related issues (n = 14) and available support services (n = 14). Conclusion: Chinese patients and caregivers expressed overall satisfaction with the WeCope resource and provided suggestions for improvement, including provision of more treatment‐related information and contact details for available support while reducing the overall resource length. [ABSTRACT FROM AUTHOR]

Objective. The number of cancer survivors is increasing, and the high prevalence of frailty not only reduces quality of life but also affects the treatment of cancer patients. This study aimed to identify the prevalence and risk factors of frailty in cancer patients and to construct a nomogram to predict the probability of frailty. Methods. Nine hundred fifty‐eight cancer patients were included in this retrospective study, randomly divided into a development set (n = 680) and a validation set (n = 278). Frailty was assessed using the Tilburg frailty indicator (TFI). Social support, medical coping styles, and psychological distress were assessed by the Social Support Self‐Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ), and distress thermometer (DT), respectively. Results. The prevalence of frailty in cancer patients was 45.93%. Cancer patients who exercised regularly, ate a balanced diet, and actively coped with diseases were less likely to become frail. The risk factors for frailty identified by a multivariate analysis were parenteral nutrition, advanced TNM staging, vegetarian diet, unemployment, psychological distress ≥4, low physical activity, and negative coping styles. These risk factors were used to construct a nomogram, and the C‐index, calibration curve, and decision curve analysis (DCA) were used to assess the performance of the nomogram. The C‐index was 0.762, and the calibration curve showed satisfactory coherence. The net benefit of the nomogram was better between threshold probabilities of 17%–96% in DCA. Conclusion. Special focus needs to be placed on frail cancer patients due to their high prevalence and severe outcomes. Clinical medical workers could use this nomogram to identify high‐risk patients and intervene early to prevent frailty. [ABSTRACT FROM AUTHOR]

Objective. Decision‐making in advanced cancer with a limited prognosis is particularly challenging: constantly evolving therapeutic algorithms with new treatment options that show marginal benefits have to be balanced with end‐of‐life decision‐making. But existing decision support tools for advanced cancer patients are rare, not routinely used in clinical practice and do not sufficiently meet patients' needs. Therefore, our project explores the experienced decision‐making process in advanced lung cancer to derive recommendations for the use of shared decision‐making in this context. Methods. 20 semistructured interviews with lung cancer patients, their relatives, and healthcare professionals were conducted. All data were transcribed verbatim and analyzed with a thematic content analysis. Results. The decision‐making process of advanced cancer patients is mainly characterized by a lack of perceived options. Physicians do not adequately present palliative care as an alternative or additional support for these patients. Being confronted with limited options that only include active cancer treatment patients tend to choose a more paternalistic decision model leaving the treatment decision to their physicians and accepting aggressive treatments uncritically. Conclusion. A paternalistic decision‐making model in advanced cancer may neglect individual wishes, values, and preferences of patients and promote a feeling of powerlessness. Empowerment of these patients is needed with context‐specific SDM tools and trainings of professionals to avoid overtreatment and facilitate the timely integration of palliative care. This trial is registered in DRKS00023674. [ABSTRACT FROM AUTHOR]

Introduction: Whilst there has been a wealth of research on benefits of physical activity (PA) in people with cancer, with three published reviews of reviews, no review of reviews has focused on older adults (65 years or older) who may have unique biological characteristics and barriers. We summarised PA effectiveness from reviews where majority of study participants were 65 years or older. Methods: Six databases were searched for systematic reviews of randomised controlled studies (RCTs)/quasi‐RCTs examining any type of PA in reviews where majority of study participants were aged 65 years or older. Two reviewers conducted the search and analysis according to PRISMA and JBI guidelines. Results: Fifteen reviews involving 76 different primary studies (5404 participants) were included. The majority (3827; 71%) had prostate cancer. PA was associated with benefits across multiple physical outcomes (muscle mass, functional performance, strength), improved fatigue and health service outcomes. In contrast to younger adults, there was no improvement in anxiety and mixed findings for quality of life and depression. Conclusion: PA is associated with multiple benefits in older adults with cancer, with some differences compared to younger individuals which may reflect biological or behavioural determinants. Future research should focus on mechanisms underlying PA effectiveness and underrepresented populations. [ABSTRACT FROM AUTHOR]

Background. To investigate the effectiveness of prehabilitation in improving physical and nutritional status in patients undergoing gastric cancer resection. Methods. A total of 136 locally advanced gastric cancer patients who planned to undergo neoadjuvant chemotherapy (NAC) plus transabdominal radical surgery were involved. All participants were divided into the prehabilitation group and the control group using the odd-even method, with 68 cases in each group. Intervention consisted of preoperative exercise and nutrition optimization. Participants were adults awaiting elective gastric resection for cancer. The primary outcomes were changes in functional ability and nutritional status, as measured by relative changes in 6 minute walking distance (6MWD) and scores on the albumin and prealbumin. Preoperative (end of the prehabilitation period) and postoperative (from 4 to 6 weeks after surgery) data were compared between the two groups. Results. All 136 patients were randomized in this study. Compared with the control group, the prehabilitation group exhibited improved functional capacity both before surgery (6MWD change) and after surgery. Furthermore, it demonstrated significantly higher levels of albumin and prealbumin before and after surgery than the control group. Conclusion. Prehabilitation in gastric cancer patients can improve preoperative functional capacity and nutritional status. Maintaining a patient's physical function and nutritional status may have a significant impact on the continuity of cancer care. [ABSTRACT FROM AUTHOR]

Background. Chemotherapy can cause a range of side effects including nausea, vomiting, diarrhea, and infection, which can have a significant impact on an individual's quality of life. Survival outcomes can be impacted when side effects are poorly managed, leading to failure to complete the defined dose of treatment. Objective. This study presents clinicians' experiences with a shared care model involving home-based community nurse (CN) support to improve side-effect management of individuals receiving chemotherapy as an outpatient. Methods. A qualitative study was conducted with CNs, cancer nurses, medical oncologists, and a general practitioner involved in the CN intervention delivered as part of a randomized controlled trial (RCT) aimed at reducing unplanned presentations to hospital of cancer patients receiving outpatient chemotherapy. Semistructured individual and focus group interviews were conducted. Key themes were identified using thematic analysis. Findings. Twenty-three healthcare professionals were interviewed. Three themes were identified: (1) being able to enhance patient-centered care and clinical practice during chemotherapy; (2) importance of effective communication and collaborative relationships between different care settings; and (3) ways to adapt the intervention for implementation in routine clinical practice. Participants reported that it was feasible for CNs to care for this patient group, and their home visits enabled preemptive symptom management. Suggestions to improve and modify the intervention to implement this care model within existing clinical care included a flexible approach, such as a blended delivery with face-to-face visits and telephone calls; a risk- or needs-based approach to prioritize patient groups more likely to benefit from the intervention; and sharing of electronic medical records for more effective collaboration and communication. Conclusions. A CN-delivered shared care model provided a feasible approach to the provision of individualized support for outpatients receiving chemotherapy. This study suggests ways to adapt this care model into existing clinical workflow and structures. This trial is registered with ACTRN12614001113640. [ABSTRACT FROM AUTHOR]

Objective. This study was to construct a ceRNA (lncRNA-miRNA-mRNA) regulatory network for prostate cancer (PCa) and to explore the prognostic correlation, key biological functions, and pathways of core RNAs. Methods. Three subgene expression matrices (miRNA, lncRNA, and mRNA expression matrix) were taken from the TCGA database and used in this investigation. Differential expression analysis and differential expression miRNAs were carried out. Next, the ceRNA (lncRNA-miRNA-mRNA) regulatory complex was used to visualize our data and show how they interacted. Ultimately, the primary molecular roles and biological pathways of PCa were identified using enrichment analysis by the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO). An effect of AC016773.1 on prostate cancer cell proliferation was investigated by knocking out AC016773.1 in an animal model. The interrelationship between AC016773.1 and hsa-mir-25 was validated using RNA immunoprecipitation technology. Results. The lncRNA, miRNA, and mRNA expression matrices obtained from the TCGA database contain 16901, 1881, and 19962 transcripts, respectively. Through differential expression analysis, we obtained 2010 de lncRNA comparative information, 75 lncRNA and miRNA interaction pairs, and 31 targeted de mRNAs. Through the differential expression analysis of RNA nodes in the ceRNA regulatory network, we found that compared with the NP group, in the PCa group, there were 14 lncRNAs upregulated and 25 lncRNAs downregulated, 1 miRNA upregulated and 3 miRNA downregulated, and 10 mRNA upregulated and 21 mRNA downregulated. In KEGG enrichment analysis, the pathways identified by targeted DE-mRNAs were mainly related to calcium signaling pathway, EGFR tyrosine kinase inhibitor resistance, melanoma, PI3K−Akt signaling pathway, and proteoglycans in cancer. In animal models, it was found that knocking down AC016773.1 significantly reduced tumor volume and weight, indicating that AC016773.1 may promote the proliferation of PCa cells. The use of RNA immunoprecipitation technology indicates a direct binding between AC016773.1 and hsa-mir-25. Conclusion. We elucidated the network regulatory relationship of lncRNA-miRNA-mRNA in PCa and further explored the key molecular functions, biological pathways, and prognostic value of targeted DE-mRNAs. [ABSTRACT FROM AUTHOR]

Background. Adherence to complete decongestion therapy (CDT) is of utmost importance for patients with breast cancer-related lymphedema (BCRL). However, past studies have demonstrated that adherence to CDT in BCRL patients is less than satisfactory. Our study aimed to describe the level of adherence to CDT among BCRL patients and utilize the Health Belief Model to analyse the key factors that influence adherence. Methods. We employed a convenient sampling method to select 158 patients with BCRL who were in the maintenance stage of CDT in a grade A tertiary tumour hospital in Guangzhou. A questionnaire survey was used to investigate patients' adherence to CDT, as well as their sociodemographic characteristics, medical history characteristics, disease knowledge, and health beliefs. Results. The CDT adherence score of BCRL patients was 96.46 ± 18.46 points, with an average score of 2.61 ± 0.50 points per item. The adherence rate was 65.18 ± 12.47%, indicating a moderate level of adherence. Factors that significantly influenced CDT adherence in BCRL patients included age under 45 years, having 0 or 1 child, experiencing 9 lymphedema symptoms, and having low levels of disease knowledge and health beliefs (p < 0.05). Conclusions. The level of adherence to CDT in BCRL patients is moderate and requires improvement. To enhance adherence to CDT, medical professionals should focus on patients who are younger, have fewer children, exhibit fewer symptoms of lymphedema, possess limited disease knowledge, and have weak health beliefs. [ABSTRACT FROM AUTHOR]

Objective. Desmoid-type fibromatosis (DF), a rare benign tumour with similar treatment options to cancer, can adversely impact people's lives, yet little qualitative research addressing patients' experiences of DF exists. The present study aimed to understand the day-to-day experiences of individuals with DF and their experiences of healthcare. Methods. Semistructured, qualitative interviews were conducted by phone or email with 20 participants. Inductive thematic analysis was performed, structured with the Framework approach. Results. Many participants reported delays in diagnosis. This was attributed to them ignoring their symptoms or to healthcare professionals lacking awareness of DF. Healthcare experiences varied, with some participants expressing good support. Others felt unsupported, viewing staff as dismissive of difficulties. Comparisons between DF and cancer were commonly discussed. Some participants felt relieved that they did not have cancer; others perceived that their needs were secondary to cancer patients and believed they were treated as less important. Participants discussed negative impact of DF on psychosocial well-being. Chronic pain and activity limitations seemed to impact mood and relationships. Conclusion. Greater awareness and understanding of DF by health professionals may help to reduce diagnostic delay and improve support. Individuals may benefit from being treated by specialist DF teams. [ABSTRACT FROM AUTHOR]

Background. Primary angiosarcoma of the breast (PAS) is a rare aggressive tumor with no standardized treatment. The aim of this study was to investigate the characteristics of all primary angiosarcoma of the breast obtained from a single center and the features peculiar to Chinese patients. Methods. The medical records at Tianjin Medical University Cancer Institute and Hospital were retrospectively searched to identify all cases of PAS treated in 2000–2019. Results. Sixteen cases of PAS were identified, and most involved the left breast. Forty percent of young patients had a history of progressive tumor enlargement with localized pain and skin color changes. The diagnostic accuracy rate was 66.7% for MRI, 75% for core-needle aspiration, and 58.3% for intraoperative fast frozen pathology. The most common surgery was modified radical mastectomy (n = 9, 56.25%). All positive margins involved the pectoralis major muscle, and these tumors' mean size was 8.2 cm. All cases were CD34 positive, and the Ki-67 index was ≥30% in 37.5%. Median local or distant recurrence-free survival was 57.6 months for low-to-moderate-grade tumors and 23.5 months for high-grade tumors. Seventy-five percent of the patients were treated with chemotherapy. The average tumor size in patients with relapse-free survival longer than 3 years was 2.2 cm. Conclusion. Young patients may have larger and softer breast tumors with skin color changes. MRI and core-needle biopsy should be performed preoperatively. A positive surgical margin at pectoralis major should be noted. Breast prosthesis may be a better reconstruction option. Adjuvant chemotherapy and/or radiotherapy should be considered for large tumors with a high Ki-67 index or high-grade tumors. [ABSTRACT FROM AUTHOR]

Aim. To describe the process of developing a resource, the "Prostate Cancer Outcomes Report Card," that provides information for men with prostate cancer and their family members about the outcomes of different treatment approaches. Methods. The project consisted of two phases. The first phase involved analysis of real-world data and translating outcomes into a format that consumers found easy to understand and interpret. The Report Card was developed in consultation with a consumer advisory group (n = 8). The second phase involved refinements of the resource through exploratory qualitative interviews with consumers (n = 14), an online survey among the general public (n = 134), and clinician feedback (n = 8). Results. Consumer engagement to explore preferences about the content and visual presentation from the end-users' perspective was crucial in designing this report. Consumers required trustworthy, comprehensive, simple, and up-to-date information collated in one place to help them understand the risks and benefits of their treatments. Presenting survival, cancer recurrence, and functional outcomes by treatment type and risk category was highly commended while data on high survival rates were considered reassuring. We identified high levels of unmet psychosocial and supportive care need, with differences in individual preferences around extent of information required. Conclusions. Communicating registry data about real-world outcomes in a consumer-friendly way may help fill a gap in information needs among prostate cancer survivors. Providing relatively simple and easily understandable evidence in a single consumer-oriented report may help prostate cancer survivors become better informed and facilitate patient-provider communication and shared decision making. [ABSTRACT FROM AUTHOR]

Purpose. The growing choice of oral anticancer medications (OAMs) delivered in pharmacies puts the patients at the center of their own therapeutic management. Patient satisfaction regarding their pharmaceutical management is particularly important for adherence to their treatment. The aim of this study was to assess the satisfaction of patients treated with OAMs regarding their dispensing in community pharmacies. Methods. A cross-sectional study was conducted with a self-questionnaire proposed to patients in hospital centers and community pharmacies. The patient's satisfaction regarding pharmacy dispensing was assessed with a visual analogue scale. Answers to questions about the quality of information they received from health professionals were recorded. The patient's adherence to their medication was assessed with the 8-item Morisky Medication Adherence Scale (MMAS-8). Symptoms and quality of life were recorded with the QLQ-C30 questionnaire. Results. Ninety-one patients were included in the analysis. The median score of satisfaction was 89 (interquartile range: 68, 100), and 49.5% had a satisfaction score ≥90/100. Satisfaction scores were higher for patients reporting information from pharmacists for the method of administration, the management of adverse effects, and drug interactions than for patients reporting no information from pharmacists. Patient satisfaction was not related to MMAS-8 scores, symptoms, or quality of life. Multivariate analysis of patient satisfaction revealed a positive relationship with information on the administration method provided by pharmacists. Conclusions. The level of information provided on OAMs to patients should be the same between pharmacists and oncologists. Good medication dispensing practices by the pharmacist are important components of patient care and satisfaction. We encourage pharmacists to provide more medication information to their patients. [ABSTRACT FROM AUTHOR]

Objective. To assess the sexual health and interest of breast cancer survivors (BCSs) in a tailored evaluation of their sexuality. Methods. A descriptive analysis on baseline sexual assessment of female BCS with genitourinary syndrome of menopause (GSM) receiving aromatase inhibitors (AIs), who have participated on an ongoing double-blinded randomized controlled trial on the efficacy and safety of laser therapy (NCT04619485), was conducted. Epidemiological and BC variables, as well as mental, vaginal, and basic sexual health assessment (self-reported sexual activity and frequency, sexual behavior, type of sexual activity and relationship status, Female Sexual Function Index (FSFI), and Body Image Scale questionnaires and 2 visual analogue scales (VASs) about sexual life disturbance and dyspareunia) were recorded. An optional specialized sexual assessment was offered. Results. Among 83 participants, 67 (80.7%) wanted sexual counseling. Half of them had a body image alteration, and 74% worsened their sexual life after receiving BC diagnosis and treatments. The sexual activity rate was 71.1%. Sexually inactive women had higher impairment of FSFI desire dimension (p = 0.0013), dyspareunia (p = 0.0114), and unsatisfaction with their sexuality (p = 0.0530) compared to sexually active women. In sexually active women, the mean FSFI and all of its dimensions showed a lower score. The most frequent sexual behavior was a combination of nonvaginal and vaginal sex, despite the high intensity of dyspareunia (mean VAS ± SD: 7.1 ± 2.1). Conclusion. Most of the BCSs with GSM receiving AI were interested in a specialized sexual consultation. Sexual activity and function were impaired, either secondary to dyspareunia or to other biopsychosocial sexual factors. [ABSTRACT FROM AUTHOR]

Cancer-related fatigue as a morbid state of physical, emotional, and mental exhaustion influencing everyday life is an important yet poorly investigated symptom in patients with cutaneous T-cell lymphomas. The aim of this study was to evaluate the prevalence of and the association between pruritus, quality of life, and fatigue in patients with cutaneous T-cell lymphomas. Mycosis fungoides and Sézary syndrome patients were invited to complete the Functional Assessment of Cancer Therapy-General (FACT-G) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) subscale questionnaire. Pruritus was assessed using the peak pruritus numeric rating scale. Half of the 38 recruited patients reported fatigue. 13 patients (34%) suffered from severe fatigue. The median (interquartile range) FACIT-Fatigue subscale score was 35.5 (25.75–43). The advanced disease stage was associated with more severe fatigue and a poorer quality of life. The FACIT-Fatigue subscale score was significantly correlated with quality of life (r = 0.8 and P < 0.0001). More than 80% of patients reported pruritus. There was no correlation between pruritus and fatigue (r = −0.19 and P = 0.26). All in all, fatigue is a common symptom of cutaneous T-cell lymphomas in early and advanced stage disease and has a strongly negative effect on cutaneous T-cell lymphoma patients' quality of life. [ABSTRACT FROM AUTHOR]

Purpose. Exercise is emerging as an adjunct therapy to cancer treatment; however, its role in older patients with advanced pancreatic cancer undergoing first-line chemotherapy is unclear. The aim of this study was to primarily provide evidence on feasibility with an exploratory examination of the initial efficacy of exercise in this clinical setting. Materials and Methods. Six patients aged 60–75 years with de novo or recurrent advanced pancreatic cancer undergoing first-line chemotherapy consented to participate in twice-weekly exercise that included resistance and aerobic training and boxing-related activities for up to 12 weeks. Patients were monitored for attendance, adherence, and adverse events. Body composition, muscle strength, functional ability, patient-reported outcome measures, and patient-reported experience measures were assessed at baseline and/or postintervention. Results. Of the 6 patients, 1 withdrew after baseline testing and 5 attended 42%–95% of planned sessions and adhered to 28%–83% of the prescribed exercise. There were no serious exercise-emergent adverse events. All 5 patients increased or maintained lean mass (0.1%–4.4%) and 4 reduced fat mass (−0.4%–−8.6%). Improvements were observed in 4 or all 5 patients for muscle strength (7.1%–75%), 5 times sit-to-stand (1.3%–21.4%), 6-m backward walk (16.5%–35.8%), and patient-reported outcomes. Furthermore, all patients perceived exercise as very helpful in managing their cancer and expressed a strong willingness to continue exercise in the future. Conclusion. A multimodal exercise program appears feasible with potential physical and psychological benefits for older patients with advanced pancreatic cancer undergoing first-line chemotherapy. Further research including a larger sample size is warranted. [ABSTRACT FROM AUTHOR]

Prostate cancer invariably impacts men's health and well-being and remains the most common male cancer. This study explored how men with prostate cancer who were scheduled for radical prostatectomy made sense of their cancer diagnosis. A narrative analysis was performed of 18 men's life stories at three different time points: preoperatively (n = 13), three months postoperatively (n = 10), and six to nine months postoperatively (n = 11). In total, 34 interviews were undertaken in Ireland to examine how men talked over time. Riessman's narrative analytic technique and structural and thematic analysis were used as the analytic framework. The following four themes emerged which reflected how men made sense of their prostate cancer diagnosis: seeking coherence, connecting through collective masculinity, rejecting a survivorship identity, and positioning prostate cancer. Seeking coherence was evident in the preoperative phase whilst the other three themes emerged in both postoperative time points. Whilst the experience of prostate cancer was an individualised one, masculine identity and narrative positioning underpinned every aspect of men's accounts. Subscription to and expression of a masculine identity underpinned all aspects of the men's narratives. In conclusion, it is recommended that care interventions targeted towards meeting the unmet needs of this group account for this highly masculinised experience. Appropriately sequenced information and support which is gender sensitive to individualised and collective identity expression is crucial. Acknowledgment of masculinised language is also recommended for men's individual and collective recovery from this life-altering experience. [ABSTRACT FROM AUTHOR]

Objective. To explore variations in patterns of care over three decades for a subgroup of rectal cancer patients in South Australia according to sociodemographic characteristics. Methods. This study evaluated three decades of retrospective data from the South Australian Clinical Cancer Registry. A total of 4,131 patients diagnosed with rectal cancer between 1982 and 2015 and treated in South Australian public hospitals were included. Study outcomes were age at diagnosis, area of primary residence, cancer stage, and primary treatment (surgery, chemotherapy, or radiotherapy). Results. There was a significantly lower likelihood of conventional therapy for the elderly. Adjusted odds of receiving surgery or radiotherapy decreased by 70% and those of receiving chemotherapy by 90% in the 80+ age group, compared to the 50–59 age group. No significant variation was detected according to area-level socioeconomic status or remoteness. Conclusion. Socioeconomic factors showed little impact on the receipt of therapies for rectal cancer patients in South Australia. Variation in treatment by age, irrespective of disease stage or period of diagnosis, requires further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Recent reproductive technology for cancer patients has provided multiple options to preserve their fertility. Preserving fertility can increase quality of life of cancer patients. However, medical service providers and patients face difficulties in the decision‐making process for the fertility preserving treatment because studies focusing on the concept of decision‐making and various intervention materials are lack. This review aims to identify the attributes of interventions of studies on decision‐making support interventions in cancer patients considering fertility preservation and provide best evidence for health professionals. Methods: PubMed, CINAHL, Embase, Cochrane CENTRAL and DBpia databases were searched. An integrated review of the literature was conducted using Whittemore and Knafl's methodology. Results: The search identified 1008 articles, of which 11 studies met eligible criteria. The attributes of the interventions were (1) provision of detailed and practical information of fertility preservation, (2) nondirective approaches to help patients to value their judgements, (3) emphasis on interactions through individualised consultations, (4) establishing connections with available resources and (5) reinforcement of decision‐making support resources. Conclusion: Health professionals must acquire current knowledge and ethical and legal standards of fertility preservation and pass this information on to patients before the formation of fertility preservation decision‐making support networks within the hospital and health systems. [ABSTRACT FROM AUTHOR]

Objectives: Routinely used performance status scales, assessing patients' suitability for cancer treatment, have limited ability to account for multimorbidity, frailty and cognition. The Clinical Frailty Scale (CFS) is a suggested alternative, but research detailing its use in oncology is limited. This study aims to evaluate if CFS is associated with prognosis and care needs on discharge in oncology inpatients. Methods: We evaluated a large, single‐centre cohort study in this research. CFS was recorded for adult inpatients at a Regional Cancer Centre. The associations between CFS, age, tumour type, discharge destination and care requirements and survival were evaluated. Results and Conclusions: A total of 676 patients were included in the study. Levels of frailty were high (Median CFS 6, 81.8% scored ≥5) and CFS correlated with performance status (R = 0.13: P = 0.047). Patients who were frail (CFS ≥ 5) were less likely to be discharged home (62.9%) compared with those who were not classed as frail (86.1%) (OR 3.6 [95%CI 2.1 to 6.3]: P < 0.001). Higher CFS was significantly associated with poorer prognosis in all ages. Solid organ malignancy (hazard ratio [HR] 2.60 [95%CI 2.05–3.32]) and CFS (HR 1.43 [95%CI 1.29–1.59]; P < 0.001) were independently associated with poorer survival. This study demonstrated that CFS may help predict prognosis in adult oncology inpatients of any age. This may aid informed shared decision‐making in this setting. Future work should establish if routine CFS measurement can aid the appropriate prescription of systemic therapy and enable early conversations about discharge planning. [ABSTRACT FROM AUTHOR]

Introduction: Existing research has found that both lung cancer patients and their informal caregivers reported higher level of emotional distress and psychological maladjustment. However, limited attention has been afforded to collective emotional experiences in patient‐caregiver dyad, especially during progression‐free survival. Objective: This study attempted to explore extrinsic emotional regulation experienced by lung cancer patients and familial caregivers in China. Methods: By adopting a qualitative descriptive approach, data were collected using face‐to‐face, in‐depth semi‐structured interviews from July to August 2021. Using purposively sampling, this study interviewed 13 patients and 7 caregivers through conjoint and individual interviews. Results: Based on data analysis, findings demonstrated emotional congruence, implicit emotional disclosure and emotional contagion within families as indicators of mutual responsiveness to cancer in patient–caregiver dyads. Furthermore, caregivers tended to adopt relationship engagement to facilitate patients to maintain mental wellness during PFS. Oncology care should promote the implement of patient‐ and family‐centred care, especially enhancing dyadic coping in emotional regulation. Conclusion: Patients and caregivers experienced mutual responsiveness to cancer‐induced emotions. Additionally, caregivers adopted relationship‐based care ethics to facilitate patients to maintain mental wellness. [ABSTRACT FROM AUTHOR]

Background: Hormonal therapies are the cornerstone of systemic adjuvant treatment of oestrogen receptor (ER) positive breast cancer. The full benefit of this treatment is obtained with long‐term adherence. However, discontinuation of hormonal therapy is common. Factors associated with non‐compliance to therapy are complex and worth of detailed evaluation. Patients and Methods: A retrospective analysis of medical records of 284 early ER‐positive breast cancer patients prescribed adjuvant hormonal therapy during a 5‐year period in a single centre was undertaken. Characteristics of the patients and their disease as well as adherence to therapy and continuation at 1 and 3 years were recorded. The group of patients that were on treatment at 3 years and the group that had discontinued therapy before 3 years were compared to identify differences predicting lack of adherence. Results: The discontinuation rate of hormonal therapy at 1 year was 13%, and the discontinuation rate at 3 years was 21.2%. Patient age and menopause status were not associated with hormone therapy adherence at 3 years. The type of hormonal therapy (aromatase inhibitor or tamoxifen) was also not associated with adherence. In contrast, patients that received adjuvant chemotherapy before starting hormonal therapy had a higher adherence to hormonal therapy (86.9% at 3 years vs. 75.7% in patients that had not received adjuvant chemotherapy, χ2p = 0.04). Among co‐morbidities, patients with a concomitant diagnosis of psychiatric disease at the time of breast cancer diagnosis were at increased risk of hormone therapy non‐adherence. Progression‐free survival and overall survival were inferior in the non‐adherent group compared with the patients who continued their hormonal therapy at 3 years. Conclusion: Adjuvant chemotherapy is associated with better subsequent adherence to hormonal therapy in early breast cancer patients. On the other hand, psychiatric co‐morbidities are associated with worse adherence. De‐escalation of adjuvant therapy guided by genomic tests leads to a significant percentage of early ER‐positive breast cancer patients not receiving chemotherapy. Non‐adherence to hormonal therapy would leave a subset of these patients with no adjuvant systemic therapy. The current results will guide efforts to increase compliance to hormonal therapies in specific groups of patients. [ABSTRACT FROM AUTHOR]

Objective: We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. Methods: A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face‐to‐face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. Results: The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer‐to‐peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. Conclusion: This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach. [ABSTRACT FROM AUTHOR]

Objective: The objective of this work is to identify unmet information needs of long‐term‐survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. Methods: Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. Results: The most important information needs were self‐management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow‐up, and indications and safety issues of pregnancy in survivors. Conclusions: Two fundamental ideas were identified: (1) Patients request information about self‐management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. Implications for cancer survivors: Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes. [ABSTRACT FROM AUTHOR]

Objective: Palliative care improves outcomes for patients with thoracic cancer; however, limited evidence exists for the benefits of this approach for caregivers. This study aimed to advance understanding of the experiences of palliative care described by bereaved caregivers. Methods: Fifteen adult caregivers completed semi‐structured interviews following prior participation in a randomised controlled trial of early referral to palliative care versus discretionary referral to palliative care. Interviews explored caregiver experiences of palliative care delivery. Interview transcripts were thematically analysed. Results: Four related themes about the experiences of palliative care were identified, each of which required sufficient time between palliative care first contact and death: 'relationship building'; 'clear communication and information'; 'access to practical support'; and 'access to psychosocial support'. The core category underpinning these themes was palliative care facilitates caregiver preparedness. Caregivers noted that palliative care played a critical role in preparing them for the future and described a sense of practical and emotional 'relief' associated with the support services made available to them. Conclusion: Our findings emphasise that palliative care can have a positive impact on caregivers' preparedness for providing the care needed by thoracic cancer patients and that this can improve the experiences of both caregivers and patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine why patients are hospitalised in the last stage of life. Methods: Our study was conducted in a large Dutch teaching hospital. We conducted a retrospective chart review of patients aged ≥18 years who died of cancer either during hospitalisation or after discharge to receive terminal care outside the hospital. We collected data about the characteristics of these hospitalisations and indicators of advance care planning. Results: Of the 264 deceased patients, 56% had died in the hospital and 44% after hospital discharge. Of all patients, 80% had been admitted to the hospital because of symptom distress. Dyspnoea (39%) and pain (33%) were the most common symptoms. Most patients underwent diagnostic procedures (laboratory tests [97%] and radiology tests [91%]) and received medical treatment (analgesics [71%] and antibiotics [55%]) during their hospitalisation. A 'Do‐Not‐Resuscitate' code had been recorded before admission in 42% of the patients and in an additional 52% during admission. Conclusion: Our study shows that patients with cancer in the last stage of life were mainly admitted to the hospital because of symptom distress. Some hospitalisations and in‐hospitals deaths may be avoided by more timely recognition of patients' impending death and start of advance care planning. [ABSTRACT FROM AUTHOR]

Objective: Clinicians' fears of taking away patients' hope is one of the barriers to advance care planning (ACP). Research on how ACP supports hope is scarce. We have taken up the challenge to specify ways in which ACP conversations may potentially support hope. Methods: In an international qualitative study, we explored ACP experiences of patients with advanced cancer and their personal representatives (PRs) within the cluster‐randomised control ACTION trial. Using deductive analysis of data obtained in interviews following the ACP conversations, this substudy reports on a theme of hope. A latent thematic analysis was performed on segments of text relevant to answer the research question. Results: Twenty patients with advanced cancer and 17 PRs from Italy, the Netherlands, Slovenia, and the United Kingdom were participating in post‐ACP interviews. Three themes reflecting elements that provide grounds for hope were constructed. ACP potentially supports hope by being (I) a meaningful activity that embraces uncertainties and difficulties; (II) an action towards an aware and empowered position; (III) an act of mutual care anchored in commitments. Conclusion: Our findings on various potentially hope supporting elements of ACP conversations provide a constructive way of thinking about hope in relation to ACP that could inform practice. [ABSTRACT FROM AUTHOR]

Objective: Physical and psychosocial effects of oral cancer result in long‐term self‐management needs. Little attention has been paid to survivors' self‐efficacy in managing their care. Study goals were to characterise self‐care self‐efficacy and evaluate socio‐demographics, disease, attitudinal factors and psychological correlates of self‐efficacy and engagement in head and neck self‐exams. Methods: Two hundred thirty‐two oral cancer survivors completed measures of socio‐demographics, self‐care self‐efficacy, head and neck self‐exams and attitudinal and psychological measures. Descriptive statistics characterised self‐efficacy. Hierarchical regressions evaluated predictors of self‐efficacy. Results: Survivors felt moderately confident in the ability to manage self‐care (M = 4.04, SD = 0.75). Survivors with more comorbidities (β = −0.125), less preparedness (β = 0.241), greater information (β = −0.191), greater support needs (β = −0.224) and higher depression (β = −0.291) reported significantly lower self‐efficacy. Head and neck self‐exam engagement (44% past month) was relatively low. Higher preparedness (OR = 2.075) and self‐exam self‐efficacy (OR = 2.606) were associated with more engagement in self‐exams. Conclusion: Many survivors report low confidence in their ability to engage in important self‐care practices. Addressing unmet information and support needs, reducing depressive symptoms and providing skill training and support may boost confidence in managing self‐care and optimise regular self‐exams. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were to describe patients' experiences of cancer care in Switzerland and explore the variation of these experiences by type of cancer. Methods: The Swiss Cancer Patient Experiences (SCAPE) study was a cross‐sectional, multicentre survey conducted in 2018. Adult patients (n = 7145) with breast, prostate, lung, colorectal, skin or haematological cancer from four large hospitals in French‐speaking Switzerland were invited to complete a survey. Logistic regressions were used to assess whether experiences varied according to cancer type, adjusting for confounders. Results: Of the 3121 persons who returned the survey (44% response rate), 2755 reporting an eligible cancer were included in the analyses. Participants' average score for overall care was 8.5 out of a maximum score of 10. Higher rates of positive experiences were found for nurse consultations (94%), diagnostic tests (85%) and inpatient care (82%). Lower positive responses were reported for support for people with cancer (70%), treatment decisions (66%), diagnosis (65%) and home care (55%). We observed non‐systematic differences in experiences of care by cancer type. Conclusions: This large study identified that cancer patient experiences can be improved in relation to communication, information and supportive care aspects. Improvement efforts should target these areas of care to enhance responsiveness of cancer care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to reach a consensus on a set of proposals to optimise the disease management of Multiple myeloma (MM) within the Spanish National Health System (SNHS) and to apply the Social Return on Investment (SROI) method to estimate their social impact. Methods: A Multidisciplinary Working Team (MWT) including MM main stakeholders was organised. A survey was administered to gather information from patients regarding the impact of MM on different life domains. A forecast‐type SROI analysis, with a 1‐year timeframe, was applied. Results: Fifteen proposals were selected, to optimise MM management, including actions for early diagnosis, psychological support, improvement of information for patients and quick access to palliative care, among others. The implementation of these proposals would benefit patients, their informal caregivers and the SNHS. The investment required would amount to 10.32 million euros with a social return of 43.31 million euros: 4.2 euros for each euro invested. According to the sensitivity analysis, this ratio could range from 3.38 to 5.20 euros from the worst to the best‐case scenario. Conclusions: The current management of MM could be optimised by implementing a set of proposals that would most likely result in an overall positive social return. [ABSTRACT FROM AUTHOR]

Introduction: Although cancer self‐help groups (CSHGs) have increased in importance in recent years, certain aspects have not yet been sufficiently investigated in studies to date. In particular, little is known about members' experiences in face‐to‐face peer led CSHGs. This systematic review aims to synthesise qualitative studies documenting personal experiences of CSHG members and to enlighten group processes and mechanisms. It focuses on benefits and challenges of participating in face‐to‐face CSHGs in studies based on qualitative research. Methods: MEDLINE, PsycINFO and PSYNDEX were used to identify relevant studies published from January 2000 to April 2022. Results: Of the 978 studies screened for eligibility, 20 studies were included in the review and were methodologically assessed using the Critical Appraisal Skills Programme. All included studies consistently indicate that participation in a peer led CSHG leads to multiple perceived benefits, that is, informational support, shared experience, learning from others, helping others as well as cultivating humour as a coping strategy. Additionally, various challenges in CSHGs were identified, that is, confrontation with the suffering of others, divergent information needs, distressing group dynamics and challenging aspects concerning leadership and sustainability. Conclusion: This indicates that groups need low‐threshold offers to be able to organise support in case of need. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore (1) the levels of quality of life (psychosocial, physical and sexual well‐being) and breast satisfaction in breast cancer patients (BCP) after immediate reconstruction (IR), considering surgery reason and surgical technique, and (2) the explanatory and predictive capacity of psychosocial well‐being on breast satisfaction, and of both on sexual well‐being. Methods: This prospective study included 36 BCP who underwent IR between June 2006 and December 2014. Results: Highest levels of quality of life were found in psychosocial well‐being and sexual well‐being, with no statistically significant differences by surgery reason or surgical technique in any quality of life indicator or breast satisfaction. Psychosocial, physical well‐being and breast satisfaction explained 56.16% of the variance in sexual well‐being, where 44.67% was attributed to psychosocial well‐being. In addition, breast satisfaction statistically significantly mediated the relationship between psychosocial and sexual well‐being, independently of physical well‐being. Conclusion: Our findings highlight the importance of IR in reducing psychological morbidity and preserving the quality of life and breast satisfaction. Furthermore, this research indicated that psychosocial well‐being should be considered a useful personal resource for improving the sexual well‐being of BCP undergoing IR both through its direct effect and the mediated effect of breast satisfaction. [ABSTRACT FROM AUTHOR]

Objective: Cancer is a global public health issue that continues to increase because of aging and adoption of cancer‐causing behaviours. In Ethiopia, cancer belongs to the second most common non‐communicable disease. Cancer patients face a range of unmet needs in multiple aspects of their lives. Supportive care is defined as essential care that helps patients to cope with cancer. This study aims to assess the predictors of unmet supportive care needs in adult cancer patients in Ethiopia. Methods: Institution‐based cross‐sectional study was done from February to March 2019 in adult cancer patients. Three hundred seventy‐one patients were interviewed using convenience sampling. Supportive care needs were used as outcome variables, dichotomized as 'no need' and 'unmet needs'. Variables with a p‐value of <0.2 were candidates for multivariable logistic regression. Results: From 371 patients, 69.8% were females with a mean age of 47 years; the commonest type of cancer was gynaecological cancer. Information about diagnosis, stage of cancer, time since diagnosis, age, wealth index, employment status, gender, type of treatment, history of recurrence, type of cancer and information about diagnosis modified by the source of information were predictors of unmet supportive care needs. Conclusions: The study emphasised the importance of considering sociodemographic, clinical and information‐related factors when dealing with cancer patients. Programmes, guidelines and services that focus on supportive care needs should be established and/or implemented. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate changes in health‐related quality of life (HR‐QoL) 1 year after surgical treatment in patients with primary resectable colon cancer and to assess whether changes at group level differ from changes at individual level. In addition, we assess which characteristics are associated with a decline of HR‐QoL. Methods: Patients with primary resectable colon cancer who received surgical treatment and adjuvant chemotherapy if indicated were selected from the Prospective Dutch ColoRectal Cancer cohort (PLCRC). HR‐QoL was assessed using EORTC‐QLQ‐C30 questionnaire before surgery and 12 months post‐surgery. Outcomes were assessed at group and individual levels. Logistic regression analysis was conducted to assess which socio‐demographic and clinical characteristics were associated with a clinically relevant decline of HR‐QoL at 12 months. Results: Of all 324 patients, the baseline level of HR‐QoL summary score was relatively high with a mean of 88.1 (SD 11.4). On group level, the change of HR‐QoL at 12 months varied between −2% for cognitive functioning and +9% for emotional functioning. On individual level, 15% of all patients experienced a clinically relevant decline in HR‐QoL summary score at 12 months. Older age, comorbidity burden or the reception of adjuvant chemotherapy was independently associated with a decline of HR‐QoL in one of the functional subscales of EORTC‐QLQ‐C30 at 12 months. Conclusion: Only trivial changes of HR‐QoL were observed after colon cancer treatment on group level, whereas on individual level, at least 1 out of 10 patients experienced a decline of HR‐QoL 12 months post‐surgery. It is important to consider individual differences while making a treatment decision. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the attitudes, practices and work‐related experiences among Swedish physicians regarding the referral process, integration and transition between oncology care and palliative care (PC). Methods: A cross‐sectional online survey was performed with a study‐specific questionnaire in 2016–2017 in south‐eastern Sweden. Physicians working with cancer patients within surgical specialties, medical specialties and paediatric oncology participated. Results: The vast majority of the 130 participating physicians (99.2%) stated that PC was beneficial for the patient and were positive about early integration of PC (65.5%). Still, only 27.6% of the participants introduced PC at an early stage of non‐curable disease. However, paediatric oncologists had a very early introduction of PC in comparison with medical specialties (p = 0.004). Almost 90% of the study population said they wanted to know that the patient had been taken care of by another care facility. Conclusions: Despite the physicians' positive attitude towards early integration and referral to PC, they often acted late in the disease trajectory. This late approach can reduce the patient's opportunity of improving quality of life during severe circumstances. There is a need for in‐depth knowledge of the physicians' challenges in order to bridge the gap between intentions and actions. [ABSTRACT FROM AUTHOR]

Objectives: Supporting cancer patients during COVID‐19 has posed unique challenges for health care providers. We investigated patient and carer–charity interactions to explore the role of charities and identify concerns expressed by patients. The study aims to address these concerns and learn how health care providers can support patients. Methods: Digital interactions on forum posts and social media were collected from four gynaecological cancer charities from March‐May 2019 (before COVID‐19) and 2020 (during COVID‐19). Thematic analysis of forum posts and semistructured charity staff interviews investigated patient and charity‐focused perspectives. Results: Thematic analysis of forum posts and charity staff interviews (n = 8) revealed three consistent themes: (1) Health care changes and the effect on cancer management concerns; (2) psychological impact of lockdown isolation and anxiety of changed treatment; (3) the complexity of shielding guidance on self‐risk assessment. Patients valued cancer charities' responses through digital and conventional methods (webinars, social media, forums, and websites). Conclusion: Gynaecological cancer patients had concerns about the risk and impact of changed treatment plans, contacting charities as the first port of call when anxious not to burden health systems. Real‐time analysis of charities' communications can be used to identify concerns and to proactively provide patient support, together with health care providers. [ABSTRACT FROM AUTHOR]

Objective: Chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with high toxicity that adversely affects physical functioning, body composition, fatigue, quality of life and treatment outcomes. Exercise interventions during treatment might counteract these negative effects. We therefore assessed the feasibility of an exercise programme for HNC patients during CRT. Methods: Forty patients were offered a tailored 10‐week endurance and resistance training with supervised and home‐based sessions. Feasibility endpoints were (1) adherence (main outcome): ≥60% attendance; (2) recruitment: ≥30%; (3) retention rate: ≥85% and (4) compliance rate: ≥60%. Physical performance, muscle strength, body composition, quality of life and fatigue were assessed pre‐ and post‐intervention. Results: Overall adherence was 54%. The recruitment rate was 36%, and the retention rate was 65%. Compliance to the supervised intervention protocol was 66%. Statistically significant decreases were found in mean grip strength, fat‐free mass and clinically relevant deteriorations on several domains of quality of life, and fatigue subscales were found. Conclusion: We conclude that this exercise programme for HNC patients during CRT in its current form is feasible for only a minority of patients. We suggest adaptations to improve adherence and retention rates for a definitive multicentre trial. Trial registration: This study is registered at the Netherlands Trial Register (NTR7305), 6 June 2018, retrospectively registered. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the stressors and contextual factors that affect the quality of life (QoL) of caregivers of advanced cancer patients and to address their caregiving experiences. Methods: The study had an embedded mixed‐methods design and was conducted in the medical oncology unit of a training and research hospital in Turkey. In the quantitative phase, 125 patients with advanced cancer and their family caregivers were included. In the qualitative phase, 21 family caregivers were included. The analysis of quantitative data was carried out using SPSS 25.0 statistical program, and qualitative data were carried out using Collaizi's seven‐step descriptive analysis approach. QoL was determined as the dependent variable and evaluated with Caregiver QoL Index‐Cancer (CQOLC). Results: The symptoms, care dependency of patients, and preparedness to the care of caregivers showed a direct impact on the CQOLC. Income level, employment status, and daily caregiving hours demonstrated a direct effect on the CQOLC. Four themes emerged from the interviews: Understanding the dynamics of the caregiving process, losing control of life during the caregiving process, limitation of socio‐economic freedom in the caregiving process, and the effort to hold on to life in the caregiving process. Conclusion: The cancer family caregiving experience model is a useful model for evaluating the QoL of caregivers from a multidimensional perspective. Health care professionals should not forget that the QoL of family caregivers should be evaluated in multiple ways, and education programmes for family members should be structured. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 pandemic's ongoing effects and long‐term implications for the mental and social state of cancer patients are not yet fully known. The current study examined cancer patients' feelings about the pandemic's long‐term impact on daily life 1 year after its outbreak in Israel and after the patient's vaccination against the virus. Methods: Ten in‐depth semi‐structured interviews were conducted with cancer patients between February and April 2021. Results and Conclusions: Findings indicated four main themes: (1) managing medical care and support from the medical staff, (2) the effect of the pandemic on social interactions; (3) the impact of the pandemic on family and social support and (4) the patients' psychological well‐being. Despite the patients being vaccinated, the full impact of the pandemic on cancer patients' mental and social states is still fully apparent. The findings reflect the need to assess and monitor the patients' mental state and social and medical needs during this complex time and the importance of developing external support networks. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the implementation of Value‐Based Healthcare principles for lung cancer patients in a large Belgian hospital. This hospital implemented a digital platform for the collection of patient‐reported outcomes and the standardisation of care pathways. Also, a follow‐up by the multidisciplinary care team was put in place. Methods: Evaluation was done by employing a mixed method approach with data analysis of all included patients (n = 201), a pilot study (n = 30) and semi‐structured interviews with the care team (n = 5). Results: Overall, 95% of all lung cancer patients of two thoracic oncologists agreed to participate in the digital follow‐up during the period January 2018 to September 2020 (201 participating patients). The response rates of those patients were high: 92% of the weekly questionnaires and 90% of the 6‐weekly ICHOM questionnaires were responded. Based on the pilot study, we conclude that questions are clear and the platform is user‐friendly for 90% of patients in the pilot. The interviews revealed that the weekly follow‐up has a positive impact on the patient–provider communication and makes it easier to discuss psychological and palliative care needs. Conclusion: This study shows a successful implementation of Value Based Healthcare with weekly digital follow‐up. Clinical trial registration is as follows: www.clinicaltrials.gov, NCT04712149. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to explore whether general practitioners (GPs) communicate with cancer patients on complementary and integrative medicine (CIM) in a patient‐centred and case‐specific manner. Methods: We designed two cases of standardised breast cancer patients and allocated 29 GPs to hold a consultation either with Case 1 or Case 2. Case 1 presented with fears of possible physical side effects of hormone treatment. Case 2 feared a loss in social functioning because of nausea and emesis as possible side effects of chemotherapy. Consultations were audiotaped and analysed using the Roter Interaction Analysis System (RIAS). We analysed whether recommended CIM treatments and GPs' focus on psychosocial or medical and therapy‐related content differed according to whether they were counselling Case 1 or Case 2. Results: In consultations with Case 1, GPs rather focused on medical and therapy‐related content and most often recommended mistletoe, diets and sports. In contrast, GPs focused on psychosocial content and they most often recommended methods of self‐care when counselling Case 2. Conclusion: The GPs in our sample reacted case‐specifically to the patients' interest in CIM. Such responsive and patient‐centred communication is a valuable resource but is often time‐consuming. Adequate training and reimbursement should therefore be considered for GPs. [ABSTRACT FROM AUTHOR]

Objective: This prospective study aimed to evaluate the performance of the 'Surprise Question' (SQ) 'Would I be surprised if this patient died in the next 12 months?' in predicting survival of 12, 6, 3 and 1 month(s), respectively, in hospitalised patients with cancer. Methods: In three hospitals, physicians were asked to answer SQs for 12/6/3/1 month(s) for inpatients with cancer. Sensitivity, specificity, positive and negative predictive values were calculated. Results: A total of 783 patients were included, of whom 51% died in the 12‐month period after inclusion. Sensitivity of the SQ predicting death within 12 months was 0.79, specificity was 0.66, the positive predictive value was 0.71 and the negative predictive value was 0.75. When the SQ concerned a shorter survival period, sensitivities and positive predictive values decreased, whereas specificities and negative predictive values increased. In multivariable logistic regression analysis, the SQ was significantly associated with mortality (OR 3.93, 95% CI 2.70–5.71, p < 0.01). Conclusions: The 12‐month SQ predicts death in patients with cancer admitted to the hospital reasonably well. Shortening the timeframe decreases sensitivities and increases specificities. The four surprise questions may help to identify patients for whom palliative care is indicated. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this review is to synthesise and present the best available evidence on the prevalence, predictors and information needs about sexual health among female Arab cancer survivors. Methods: The databases searched included MEDLINE, Embase and CINAHL from inception of the database until March 2020. The review was undertaken according to the JBI guidelines. Proportional meta‐analysis using a random effects model was used for statistical pooling through JBI SUMARI. Results: Seven studies involving female Arab cancer survivors were included in the review. The overall prevalence of sexual dysfunction ranged from 16.7 to 67% (pooled estimate 51%, 95% CIs 21.7% to 80.2%). Dyspareunia and erectile dysfunction were the two main types of sexual dysfunction reported after diagnosis, and the overall prevalence ranged from 42.5% to 65% and 38% to 61%, respectively. The prevalence of vaginal dryness was ranged from 19.8% to 54.2%, and dyspareunia ranged from 22.2% to 65%. The lack of sexuality information and communication with health care providers (HCPs) was also reported in the included studies. Conclusion: Cancer and its treatment may result in significant difficulties with sexual activity and sexual functioning among cancer survivor. Communication between the health care professionals and cancer survivors is essential to overcome this problem and improve the quality of life of female Arab cancer survivors. [ABSTRACT FROM AUTHOR]

Objectives: Receipt of a positive Papanicolaou screening result and subsequent referral for diagnostic tests can cause psychological stress. Still, not enough is known about depression before and after the diagnostic test in these women. The aim of this study was to determine the burden and predictors of depressive symptoms prior to and after diagnostic investigations in women who had received a positive Papanicolaou screening result. Methods: This was a cross‐sectional study. Study cohort comprised women who received an abnormal Papanicolaou screening result. Women completed the socio‐demographic questionnaire and 'The Center for Epidemiologic Studies Depression, CES‐D' questionnaire before and after diagnostic tests (colposcopy/biopsy/endocervical curettage) to assess factors related to depression. Results: No significant difference was noted in the frequency of depressive symptoms (CES‐D score ≥ 16) before and after diagnostic investigations, but the mean score on CES‐D scale showed a significant difference before and after diagnostic investigations (13.98 ± 9.56 and 12.74 ± 9.15, respectively). A significant predictor of depression before diagnostic investigations was spontaneous abortion, whereas family history of other gynaecological cancers was a predictor of depression after diagnostic investigations. Conclusions: Our findings could contribute to improving the rates of cervical cancer screening, by identifying women at risk for depression before and after investigations. [ABSTRACT FROM AUTHOR]

Objective: Patients with operable lung cancer experience physical and psychosocial challenges early in their treatment trajectory. However, these patients have unmet needs for a dialogue with clinicians and report that especially psychosocial challenges are not addressed in the clinical encounter. Aiming to understand the reasons for this, this study explores dominant narratives about operable lung cancer. Methods: An ethnographic study was conducted at a Danish hospital providing surgery for lung cancer. Interactions between patients, relatives and clinicians were observed during hospitalisation. Ten patients were included from September 2019 to March 2020. Results: One overarching dominant narrative of 'being lucky' was found, supported by three narrative subthemes, related to different aspects of the treatment. First, the possibility of surgical treatment was 'like winning the lottery'. Second, surgery was a minor intervention like 'a quiet day at the office'. Third, even if adjuvant chemotherapy was necessary, as long as the surgery went well, it was 'good news' in the outpatient clinic. Conclusion: 'Being lucky' is a dominant restitution narrative about operable lung cancer. A predominance of restitution narratives implies that clinicians are the active party, while patients remain passive, which limits their perspective and thus silences their concerns unrelated to curative treatment. [ABSTRACT FROM AUTHOR]

Objective: Evidence on the benefits of physical activity (PA) during cancer has caused a paradigm shift from people with cancer being advised to save energy (rest paradigm) to guidelines recommending them to engage in regular PA (activity paradigm). This study examined the rest and the activity paradigm among people with cancer based on the theory of planned behaviour (TPB). Methods: A cross‐sectional survey was completed by N = 1244 people (58% women; M = 59.95 years) with breast, prostate and colorectal cancer, including 15 items on rest and activity attitudes. To explain the intention to engage in PA, hierarchical regression analyses were calculated. Results: The two‐dimensional structure of attitudes (rest and activity) was confirmed. The agreement with the activity paradigm (M = 4.11; SD = 0.78) was higher compared to the rest paradigm (M = 2.56; SD = 0.78, p <.001). The TPB was an appropriate model to explain the intention to engage in PA (R2 =.59), showing that the activity paradigm, but not the rest paradigm, was significantly associated with participants' intention for PA. Conclusion: Results indicate that the paradigm shift has successfully reached attitudes of people with cancer. Interventions focusing on the benefits of PA rather than addressing rest cognitions promise higher effectiveness in affecting PA levels. Clinical trial registration number: NCT02678832. [ABSTRACT FROM AUTHOR]

Objective: Patients treated for colon cancer report many symptoms that affect quality of life (QoL). Survivorship care aims at QoL improvement. In this study, we assess associations between symptoms and seeking supportive care and lower QoL and QoL changes overtime during survivorship care. Methods: A prospective cohort of colon cancer survivors. Questionnaires are administered at inclusion and 6 months later to evaluate symptoms, functioning and seeking supportive care including associations with QoL, using the EORTC QLQ‐C30. Results: The mean QoL score at the first questionnaire was 82 (scale 1–100), which improved over time. Pain, bowel symptoms and problems in physical, role, cognitive or social functioning are associated with lower QoL at inclusion but are not associated with QoL changes over time. Seeking support for lower bowel symptoms, physical functioning or fatigue is associated with lower QoL. After 6 months, seeking support for upper bowel symptoms or physical functioning is associated with a tendency towards less QoL improvement. Conclusion: QoL of colon cancer survivors improves over 6 months, but seeking support for specific symptoms barely contribute to this improvement. Implications: This study confirms the importance of addressing symptoms, problems related to functioning and seeking supportive care during survivorship care. [ABSTRACT FROM AUTHOR]