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Purpose: In lung cancer, the preservation of well-being is warranted given the limited prognosis. Chemotherapy may negatively influence health-related quality of life (HRQoL) due to adverse events. However, patients' judgement about this negative impact is not well understood. We examined the relationship between expectations, feelings about side effects, and satisfaction with therapy and (HR)QoL in advanced-stage thoracic cancer and investigated which of these factors has the highest impact on (HR)QoL., Methods: Sixty-nine patients completed the Cancer Therapy Satisfaction Questionnaire (CTSQ), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Multiple regression analyses were performed to investigate the relation of the CTSQ domains (i.e., expectations of therapy, feelings about side effects, satisfaction with therapy) with (HR)QoL and simple regression analyses to identify the factors of the CTSQ domain that was most often associated with (HR)QoL., Results: Feelings about side effects were associated with the (HR)QoL domain/scale scores (i.e., WHOQOL-BREF domains: β = 0.36 to 0.58; EORTC QLQ-C30 scales: β = 0.33 to 0.61) except social relationships of the WHOQOL-BREF. Low-grade adverse events were related to feelings about side effects (β = - 0.326; P = 0.007)., Conclusions: Patients experiencing negative feelings about side effects have worse (HR)QoL. Additional care should be provided to prevent low-grade adverse events.

Purpose: To determine which health care provider and what timing is considered most suitable to discuss sexual and relational changes after prostate cancer treatment according to the point of view of men and their partners., Methods: A cross-sectional survey was conducted among men diagnosed with prostate cancer or treated after active surveillance, who received laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy, and/or hormonal therapy. If applicable, partners were included as well., Results: In this survey, 253 men and 174 partners participated. Mean age of participating men was 69.3 years (SD 6.9, range 45-89). The majority (77.8%) was married and average length of relationship was 40.3 years (SD 14.1, range 2-64). Out of 250 men, 80.5% suffered from moderate to severe erectile dysfunction. Half of them (50.2%, n = 101) was treated for erectile dysfunction and great part was partially (30.7%, n = 31) up to not satisfied (25.7%, n = 26). Half of the partners (50.6%, n = 81) found it difficult to cope with sexual changes. A standard consultation with a urologist-sexologist to discuss altered sexuality is considered preferable by 74.7% (n = 183). Three months after treatment was the most suitable timing according to 47.6% (n = 49)., Conclusions: During follow-up consultations, little attention is paid to the impact of treatment-induced sexual dysfunction on the relationship of men with prostate cancer and their partners. A standard consultation with a urologist-sexologist 3 months after treatment to discuss sexual and relational issues is considered as most preferable.

Purpose: This study examined the individual and combined effect of having colorectal cancer (CRC) and diabetes mellitus (DM) on health-related quality of life (HRQoL) and sexual functioning., Methods: Data from questionnaires collected in 2010 among CRC patients and a sample of the general Dutch population were used. All persons older than 60 years were included in this study. DM prevalence among the CRC sample as well as the sample of the general population was self-reported. HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire version 3.0 (QLQ-C30), and sexual functioning was assessed with four scales from the EORTC-QLQ-CR38., Results: In total 624 persons without CRC and DM, 78 persons with DM only, 1,731 with CRC only, and 328 with both CRC and DM were included. Having both CRC and DM did not result in lower HRQoL and sexual functioning than the sum of the individual effects of both diseases. CRC, irrespective of having DM, was associated with lower scores on most EORTC-QLQ-C30 subscales, except global health, pain, and appetite loss. CRC was also independently associated with more erection problems among males. DM, irrespective of having CRC, was associated with lower physical functioning and more symptoms of dyspnea., Conclusions: Having both CRC and DM did not result in lower HRQoL and sexual functioning than the sum of the individual effects of both diseases. As CRC was found to be consistently associated with lower functioning and more symptoms, CRC and its treatment seem to contribute stronger to lower HRQoL and sexual functioning compared with DM.

Purpose: Sexual dysfunction among patients with colorectal cancer is frequently reported. Studies examining patients' sexual health care needs are rare. We examined the sexual health care needs after colorectal cancer treatment according to patients, partners, and health care professionals (HCPs). Factors that impede or facilitate the quality of this care were identified., Method: Participants were recruited from three Dutch hospitals: St. Elisabeth, TweeSteden, and Catharina hospitals. Patients (n = 21), partners (n = 9), and 10 HCPs participated in eight focus groups., Results: It is important to regularly evaluate and manage sexual issues. This does not always occur. Almost all participants reported a lack of knowledge and feelings of embarrassment or inappropriateness as barriers to discuss sexuality. HCPs reported stereotypical assumptions regarding the need for care based on age, sex, and partner status. The HCPs debated on whose responsibility it is that sexuality is discussed with patients. Factors within the organization, such as insufficient re-discussion of sexuality during (long-term) follow-up and unsatisfactory (knowledge of the) referral system impeded sexual health care. The HCPs could facilitate adequate sexual health care by providing patient-tailored information and permission to discuss sex, normalizing sexual issues, and establishing an adequate referral system. It is up to the patients and partners to demarcate the extent of sexual health care needed., Conclusions: Our findings illustrate the need for patient-tailored sexual health care and the complexity of providing/receiving this care. An adequate referral system and training are needed to help HCPs engage in providing satisfactory sexual health care.

Purpose: The aim of this qualitative study was to examine the ways in which breast cancer survivors cope with fear of recurrence., Methods: Three focus groups were held with breast cancer survivors. Focus group interviews were recorded, transcribed verbatim, and analyzed using qualitative techniques. Coding was done on two levels: styles and strategies., Results: Twenty-seven women participated. The majority of the women (74 %) were a little anxious, and some patients (11 %) were somewhat anxious about the possibility of cancer recurrence. Most women (74 %) indicated to think a few times a month about the possibility of cancer recurrence. Different coping styles were reported, but commonly, women (80 %) reported an emotion-focused coping strategy. About half of the women (49 %) used passive or avoidant coping styles., Conclusion: The emotion-focused coping strategy was most commonly used. This information can be used to provide tailored psychosocial care.

Purpose: The aim of this study was to estimate the minimal clinical important difference (MCID) of the World Health Organization Quality of Life assessment instrument (WHOQOL-100) for women with early-stage breast cancer. If the MCID is known, then the instrument is also useful for individual patients and thus useful in clinical practice. In this study, the MCID is the smallest change in quality of life (QOL) scores considered clinically relevant for patients., Methods: Data were derived from a prospective study in which 223 women with early-stage breast cancer and 383 women with benign breast problems completed the WHOQOL-100. MCID values were determined by two distribution-based methods (0.5 standard deviation (SD) and 1 standard error of measurement (SEM)) and an anchor-based method., Results: For 0.5 SD, MCID estimates ranged from 0.64 to 0.94, and for 1 SEM, MCID estimates ranged from 0.69 to 1.18. The anchor-based approach resulted in MCID estimates ranging from -1.56 to -0.71 for decline and from 0.51 to 1.27 for improvement., Conclusion: A change in score of 1 on the WHOQOL-100 is proposed as the MCID for women with early-stage breast cancer.

Purpose: Recently, the Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC), a screening instrument specific for patients with early-stage breast cancer, was developed. The aim of this study was to further examine the psychometric properties of the PDQ-BC, in particular the subscales social support, sexual problems and financial problems., Methods: Before patients received treatment (N = 123), they completed the PDQ-BC, the World Health Organization Quality of Life (WHOQOL-100) and the Center for Epidemiologic Studies Depression Scale (CES-D)., Results: Floor effects were present in 44% of the subscales, whereas ceiling effects were only found in the social support subscale (11%). The PDQ-BC subscales social support, sexual problems and financial problems were highly correlated with the corresponding WHOQOL-100 facets social support, sexual activity and financial resources. Furthermore, the subscale depressive symptoms (PDQ-BC) was highly significantly correlated with the CES-D. Low correlations were found between the PDQ-BC subscales and questionnaires that were expected to be unrelated. Exceptions are the subscales trait anxiety and state anxiety, which had a high correlation with the CES-D. The Cronbach's alpha coefficients of the subscales trait anxiety, state anxiety, depressive symptoms, body image and physical problems ranged from 0.70 to 0.87. Social problems had a low consistency (0.39). Corrected item-total correlations confirmed the PDQ-BC structure., Conclusions: The PDQ-BC has expected floor effects, few ceiling effects and sufficient internal consistency. Furthermore, the construct validity on the PDQ-BC subscales social support, sexual problems and financial problems was good. Thus, the PDQ-BC can be used to screen psychosocial problems in patients with early-stage breast cancer as part of routine care.

Purpose: The aim of the present study was to develop a short, easy-to-use, and acceptable psychosocial screening instrument specific for breast cancer patients., Methods: Before the start of adjuvant chemotherapy, 164 (98.8%) women completed the Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC) as part of routine care. The PDQ-BC consists of questions about psychological risk factors (i.e., trait anxiety and (lack of) social support), psychosocial problems (i.e., state anxiety and depressive symptoms), social problems, physical problems, body image, financial problems, sexual problems, clinical factors (type of surgery, adjuvant treatment other than chemotherapy and psychiatric morbidity), and demographic factors (marital status, age, and age of children)., Results: On average, patients indicated that they needed 5 min to complete the PDQ-BC. All subscales were significantly correlated with each other, except the correlations of social support with physical problems and body image. Confirmatory factor analysis supported the internal structure of the PDQ-BC (comparative fit index = 0.95 (χ(2)(24) = 43.3), p = 0.009; non-normed fit index = 0.91; root mean square error of approximation = 0.073). The internal consistency (Cronbach's alphas) of the subscales trait anxiety, state anxiety, depressive symptoms, body image, social problems, and physical problems were 0.88, 0.85, 0.86, 0.79, 0.42, and 0.69, respectively., Conclusion: The PDQ-BC is an easy-to-complete, acceptable, non-burdensome, and short screening instrument for routine use in breast cancer patient care. This instrument facilitates a greater awareness of the concerns and needs for breast cancer patients care during treatment with chemotherapy and the follow-up. It is linked to a good referral system to guide allocation to the different levels of psychosocial care providers.

Goals of Work: This study examines the relationships between personality, on the one hand, and perceived availability of social support (PASS) and satisfaction with received social support (SRSS), on the other hand, in women with early stage breast cancer (BC). In addition, this study examined whether a stressful event (i.e., diagnosis) is associated with quality of life (QOL), when controlling for PASS and SRSS., Patients and Method: Women were assessed on PASS and SRSS (World Health Organization QOL assessment instrument-100) before diagnosis (time 1) and 1 (time 2), 3 (time 3), 6 (time 4), 12 (time 5), and 24 months (time 6) after surgical treatment. Personality (neuroticism extraversion openness five-factor inventory and state trait anxiety inventory-trait scale) and fatigue (fatigue assessment scale) were assessed at time 1., Main Results: Agreeableness and fatigue predicted PASS and SRSS at time 5 and time 6. Trait anxiety had a negative effect on SRSS (ss = -0.22, p < .05). In addition, having a job was negatively associated with SRSS (time 6, ss = -0.28, p < .05). Across time, women reported a decrease in PASS and SRSS. Path models, used to test whether PASS and/or SRSS functioned as mediators of the link between diagnosis and QOL, reached adequate fit., Conclusions: Besides factors, like fatigue and having a job, personality factors substantially influence the way women with early stage BC perceive social support. Knowledge about these underlying mechanisms of social support is useful for the development of tailor-made interventions. Professionals should be aware of the importance of social support. They should check whether patients have sufficient significant others in their social environment and be sensitive to potential discrepancies patients might experience between availability and adequacy of social support.