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Abstract Background Systemic edema is an adverse effect of docetaxel chemotherapy and causes distress to patients, including those receiving this agent for breast cancer. However, its characteristics and factors related to its effect on quality of life (QoL) have not been adequately investigated. In this study, we assessed systemic edema quantitatively, explored related factors, and evaluated QoL in patients receiving docetaxel for breast cancer. Methods The study had a prospective cohort design and included 37 patients with no known history of swelling who were treated with docetaxel between September 2019 and April 2022. Patients were examined at the start, middle, and end of their course of treatment and 1 and 2 months later. Body water content, body mass, fat mass, and muscle mass were quantified using bioelectrical impedance analysis. Systemic edema was evaluated with reference to the Common Terminology Criteria for Adverse Events. The timing of development of systemic edema at any anatomical site that was grade 2 or worse was recorded. QoL was assessed using the Quality of Life-Anti Cancer Drug scale. Nutrition was evaluated using the Brief-type self-administered diet history questionnaire. Multivariable logistic regression analysis was performed to identify related factors. QoL was also compared between patients with edema and those without edema. Results Systemic edema developed in 67% of the study participants and was most prevalent at the end of treatment. Body fat mass (adjusted odds ratio [aOR] 0.802, 95% confidence interval [CI] 0.651–0.988, p = 0.038), disease stage (aOR 3.279, 95% CI 0.493–21.793, p = 0.219), and history of alcohol consumption (aOR 0.141, 95% CI 0.013–1.521, p = 0.106) were identified as risk factors for docetaxel-induced edema. Participants who developed systemic edema experienced more physical, vital, and emotional distress 1 month after treatment than those who did not. There was no association between systemic edema and nutrition. Conclusions Systemic edema may develop after treatment with docetaxel and increase distress in patients with a high body fat mass. Patients at risk of systemic edema should be informed in advance about the potential frequency, location, and timing of its onset and encouraged to self-manage this condition.

Abstract Background Fatigue during radiation therapy in women with breast cancer can decrease quality of life (QOL), yet it is often underestimated and needs to be evaluated objectively. This longitudinal study aimed to evaluate fatigue and QOL of women with breast cancer undergoing radiotherapy with a simple autonomic function measurement. Methods Women with breast cancer who underwent postoperative radiotherapy in eight cancer care hospitals in Chubu and Kinki regions in Japan were recruited between October 2021 and June 2022. The women underwent a self-administered questionnaire that included the Cancer Fatigue Scale (CFS) and the Short Form-8 Health Survey (SF-8) and an autonomic nervous function measurement using a simple, non-invasive device before (T0, baseline), mid (T1), and at the end (T2) of treatment. Results The 57 women showed similar trends, with CFS scores and log LF/HF ratio being the highest at T0 and significantly decreasing at T1 (both p

PurposeAlthough exercise is recommended for cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN), the effective types of exercise for preventing and treating CIPN remain unclear. This systematic review and network meta-analysis (NMA) aimed to evaluate the comparative effects of exercise on CIPN.MethodsWe included relevant randomized controlled trials (RCTs) identified in a 2019 systematic review that evaluated the effects of exercise on CIPN and conducted an additional search for RCTs published until 2023. We evaluated the risk of bias for each RCT; the comparative effectiveness of exercise on patient-reported quality of life (QOL) through an NMA; and the effectiveness of exercise on QOL scores, patient-reported CIPN symptoms, and pain through additional meta-analyses.ResultsTwelve studies (exercise, n = 540; control, n = 527) comparing 8 exercise interventions were included in the analysis. All studies were determined to have a high risk of bias. The meta-analyses showed significantly improved QOL [standard mean differences (SMD) 0.45; 95% confidence interval (CI) = 0.12 to 0.78] and CIPN symptoms (SMD 0.46; 95% CI = 0.11 to 0.82). No severe adverse events were reported. Pain tended to improve with exercise (SMD 0.84; 95% CI = −0.11 to 1.80). An NMA suggested that the interventions of a combination of balance and strength training showed a significant improvement in QOL scores compared to the control.ConclusionExercise interventions may be beneficial for improving QOL and CIPN symptoms. High-quality large clinical trials and data are needed to conclude that exercise is beneficial and safe.

Objective: This study aimed to investigate quality of life (QOL) improvement in long-term cancer survivors using complementary therapy (CT) as mind–body practice. Methods: A quasi-experimental study including intervention and control groups was conducted. Participants in the intervention group engaged in CTs, including music therapy, progressive muscle relaxation, and deep-breathing exercises for 8 weeks at home. QOL was evaluated in both the groups using Short Form-8 (SF-8) questionnaire before the experiment and at 4 and 8 weeks after starting the experiment. To examine QOL, we compared SF-8 subscale scores, the physical and mental component summaries of QOL. Results: Cancer survivors were assigned to the intervention and control groups, comprising 69 and 59 individuals. There were no significant differences in QOL between the two groups with low scores, but there was a significant difference in the mental aspect of QOL in 4 weeks, indicating that the intervention group was lower than the control group. Meanwhile, the intervention group tended to experience increased changes in the mental aspect of QOL in 8 weeks compared to 4 weeks, although there was no significant difference. Conclusions: CT did not exhibit an effect on QOL among cancer survivors, especially in 4 weeks. This might have been due to sample size, participants' potential low compliance resulting in an inability to confirm whether the CTs were performed accurately and continuously, and consideration of what CT suited them. Meanwhile, CT may require a longer time to increase QOL. We recommend further studies to address these factors when conducting CT as mind–body practice.

Objective: The present study aims to describe fall-related self-efficacy as perceived by patients with chemotherapy-induced peripheral neuropathy (CIPN). The characteristics of patients associated with low perceived self-efficacy of preventing falls were investigated. Methods: A cross-sectional study of four hospitals in Japan. In this study, 100 outpatients who were receiving chemotherapy for cancer and experiencing CIPN were recruited. Participants completed an anonymous, self-administered questionnaire. Self-efficacy was measured with the falling self-efficacy (FSE) scale, and the severity and impact of CIPN was assessed with the Comprehensive Assessment Scale for CIPN in Survivors of Cancer (CAS-CIPN). Data about the demographic information of the patients, cancer diagnosis and treatment, pain and fatigue symptoms, and history of previous falls were collected. Logistic regression analysis was used to assess relationships between variables. Results: A total of 81 (81.0%) participants with CIPN completed the questionnaire. They reported experiencing fear of falling during their daily activities, which include the act of standing up, walking, and using the stairs. Small events, such as unstable postures and uncomfortable situations, affected their confidence of preventing falls. Logistic regression revealed that low FSE scores were significantly associated with female sex (P = 0.022), low body mass index (BMI;P= 0.026), and the CAS-CIPN score (P < 0.001). Conclusions: Female patients with CIPN and low BMI might have an increased need for enhanced fall-related self-efficacy. A comprehensive assessment of CIPN in patients at risk of low FSE scores is likely to be beneficial.

Objective: This study aimed to evaluate the psychometric properties of the Japanese version of the Cancer Survivors' Unmet Needs (CaSUN-J) scale among cancer survivors in Japan. Methods: The CaSUN-J was developed using standardized translation methodology. Content validity was evaluated by a group of experts, and a pilot test was conducted with a convenience sample of 10 cancer patients. A total of 183 Japanese cancer survivors completed the CaSUN-J. The internal consistency of the scale was examined with Cronbach's α. Construct validity was analyzed using correlations with the physical effects, quality of life (QoL), and age. To assess the factorial validity of the CaSUN-J, confirmatory factor analysis (CFA) was performed. Results: The CaSUN-J indicated good readability and high content validity for use as an assessment tool among Japanese cancer survivors. All Cronbach's α coefficients were above the minimum acceptable criterion of ≥0.70. For construct validity, higher physical effect scores, as well as poorer QoL scores and younger patients, were significantly positively associated with higher levels of needs. CFA indicated that the five-factor structure of the CaSUN-J was a good fit to the data. Conclusions: The CaSUN-J can serve as a valid and reliable tool to evaluate unmet needs among Japanese cancer survivors.

Women with breast cancer receive support from their partners to deal with the side effects of therapies over the cancer trajectory. Hormonal therapy (HT) is usually given after completing other treatments, and women receiving HT reclaim their normal life. This may lead to changes in support from their partners. Therefore, we explored women's perceptions of the support provided by their male partners in managing the side effects of adjuvant HT. We conducted semi-structured interviews with 10 women who received HT and recognized their partners as a main source of support. An interview guide was used to explore their experiences of treatment side effects, the contents of support received from their partners, their need for support, and their overall relationship with their partners. Interviews were analysed by content analysis. A theme on how participants perceived support from their partners was formulated as “Support not corresponding to transition to a new treatment” with the following categories: “Shrinking support,” “Primacy of partner,” and “Solitary new treatment.” Participants felt lack of support from their partners because their partners did not understand their experience of the side effects induced by HT. Unlike the side effects of past treatments such as surgery and chemotherapy, side effects of HT cannot be observed and are highly subjective. Their partners often failed to notice these symptoms and provided little support. Nevertheless, participants aimed to accept the existing support without asking for more. They were left alone in the continuing trajectory of breast cancer. After starting HT, women entered a new treatment phase in which less understanding and support was provided by partners. Educational support for couples may enable sharing of subjective symptoms that are not obvious to partners and improve outcomes by facilitating partner engagement and support.

This study investigated the associations of self-management (SM) skills and characteristics in participants with upper-limb lymphoedema (ULL) 12 months after breast cancer surgery The 44 women in the study received preventative education after surgery in 2019-2020. ULL was defined according to the Common Terminology Criteria for Adverse Events (CTCAE) grading system. Self-management ability was assessed using the Lymphedema SM Skill Scale and participants' characteristics using the Hospital Anxiety and Depression Scale (HADS). Participants over 65 years of age and those with a higher HADS score tended to have poorer SM skills, as did those with high school education (P=0.045). SM skills for observation of swelling and preventing deterioration were less performed in participants with grade 0 ULL than in those with grade 1 and 2. Participants with grade 0 ULL may benefit from re-education at 12 months postoperatively, and women aged older than 65 years, those with mental distress, and those with a high school educational level may require longer-term support to prevent severe lymphoedema compared to those with higher levels of education and without mental distress. This study suggested the need for adequate assessment of patient characteristics to educate clinicians on the frontline of preventing severe lymphoedema. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the performance of self-management skills and associated factors for subclinical lymphoedema in gynaecological cancer patients who had been educated on lymphoedema prevention. Methods: This cross-sectional study included 69 patients in the period 12--18 months postoperatively. We assessed self-management skills on an 11-item scale comprising 'Observe swelling', 'Maintain physical condition', and 'Prevent deterioration' subscales. The patients' demographic and clinical backgrounds and understanding of the lymphoedema prevention education were analysed as potential associated factors. Results: Although 87% of patients understood the education, only 19% performed the skill 'Observe swelling'. The skill 'Maintain physical condition' was performed by 39% of patients, which was the highest among all the subscales. A history of undergoing radiotherapy was significantly associated with rarely seeking help from others in the skill of 'Maintain physical condition'. Conclusion: The performance of SM skills was not equivalent to the understanding of education. It is necessary to re-evaluate the timing and contents of the education for early detection of lymphoedema. Ongoing nursing support would also be needed. [ABSTRACT FROM AUTHOR]