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Purpose: This systematic review and meta-analysis aimed to examine the impact of global quality of life (QOL) on mortality risk in patients with cancer, considering cancer type and timepoint of QOL assessment., Methods: A systematic search was conducted using Cumulated Index to Nursing and Allied Health Literature, PubMed/MEDLINE, and Scopus databases from inception to December 2022. Observational studies that assessed QOL and examined mortality risk in patients with cancer were extracted. Subgroup analyses were performed for cancer types and timepoints of QOL assessment., Results: Overall, global QOL was significantly associated with mortality risk (hazard ratio: 1.06, 95% confidence interval: 1.05-1.07; p < 0.00001). A subgroup analysis based on cancer type demonstrated that lung, head and neck, breast, esophagus, colon, prostate, hematologic, liver, gynecologic, stomach, brain, bladder, bone and soft tissue, and mixed type cancers were significantly associated with mortality risk; however, melanoma and pancreatic cancer were not significantly associated with mortality risk. Additionally, global QOL was associated with mortality risk at all timepoints (pretreatment, posttreatment, and palliative phase); pretreatment QOL had the largest impact, followed by posttreatment QOL., Conclusion: These findings provide evidence that QOL is associated with mortality risk in patients with cancer at any timepoint. These results indicate the importance of evaluating the QOL and supportive interventions to improve QOL in any phase., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

A current challenge in breast cancer (BC) patients is how to reduce the side effects of cancer and cancer treatments and prevent a decrease in quality of life (QoL). Neurotoxic side effects, especially from chemotherapy, are present in up to 75% of women with BC, which implies a large impact on QoL. There is a special interest in the preventive possibilities of therapeutic exercise (TE) for these neurological sequelae, and the benefits of TE could be improved when it is combined with vagal activation techniques (VATs). This superiority randomized controlled trial aims to examine the feasibility and efficacy of an 8-week multimodal intervention (ATENTO) based on moderate-vigorous intensity and individualized TE (aerobic and strength exercises) and VAT (myofascial and breathing exercises), on neurotoxicity prevention in women with BC before starting adjuvant chemotherapy (ATENTO-B) versus throughout adjuvant chemotherapy (ATENTO-T). A sample of 56 women newly diagnosed with BC, as calculated with a power of 85%, will be randomly allocated into these two groups. This study could provide an impetus for the introduction of early multimodal intervention methods to prevent neurotoxicity and consequently avoid the QoL deterioration that BC patients presently suffer throughout their treatments., (© 2021 The Authors. Research in Nursing & Health published by Wiley Periodicals LLC.)

Purpose: Cancer patients often report low self-esteem and high emotional distress. Two factors seem particularly linked to these symptoms: emotion regulation strategies and mindfulness. The interest of hypnosis and self-care to relieve these symptoms is not well documented. Our randomized controlled trial aimed at assessing the effect of a group intervention combining self-hypnosis and self-care on self-esteem, emotional distress, emotion regulation, and mindfulness abilities of post-treatment cancer patients, as well as investigating the links between these variables., Methods: One hundred and four patients who had suffered from cancer were randomized into the intervention group (N = 52) and the wait-list control group (N = 52). They had to answer questionnaires before (T1) and after the intervention (T2). Nine men were excluded from the analyses, leading to a final sample of 95 women with cancer. Group-by-time changes were assessed with MANOVA, and associations with self-esteem and emotional distress were investigated with hierarchical linear regression models., Results: Participants in the intervention group (mean age = 51.65; SD = 12.54) reported better self-esteem, lower emotional distress, a decreased use of maladaptive emotion regulation strategies, and more mindfulness abilities after the intervention, compared to the WLCG. This increase in mindfulness explained 33% of the improvement of self-esteem and 41.6% of the decrease of emotional distress in the intervention group. Self-esteem and emotional distress also predicted each other., Conclusion: Our study showed the efficacy of our hypnosis-based intervention to improve all the investigated variables. Mindfulness predicted the improvement of self-esteem and emotional distress. The primary impact of our intervention on mindfulness abilities seems to explain, at least in part, its efficacy. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.

Purpose: Small cell lung cancer (SCLC) is a highly fatal disease associated with significant morbidity, with a need for real-world symptom and health utility score (HUS) data. HUS can be measured using an EQ-5D-5L questionnaire, however most captured data is available in non-SCLC (NSCLC) only. As new treatment regimens become available in SCLC it becomes important to understand factors which influence health-related quality of life and health utility., Methods: A prospective observational cohort study (2012-2017) of ambulatory histologically confirmed SCLC evaluated patient-reported EQ-5D-5L-derived HUS, toxicity and symptoms. A set of NSCLC patients was used to compare differential factors affecting HUS. Clinical and demographic factors were evaluated for differential interactions between lung cancer types. Comorbidity scores were documented for each patient., Results: In 75 SCLC and 150 NSCLC patients, those with SCLC had lower mean HUS ((SCLC vs NSCLC: mean 0.69 vs 0.79); (p < 0.001)) when clinically stable and with progressive disease: ((SCLC mean HUS = 0.60 vs NSCLC mean HUS = 0.77), (p = 0.04)). SCLC patients also had higher comorbidity scores ((1.11 vs 0.73); (p < 0.015)). In multivariable analyses, increased symptom severity and comorbidity scores decreased HUS in both SCLC and NSCLC (p < 0.001); however, only comorbidity scores differentially affected HUS (p < 0.0001), with a greater reduction of HUS adjusted per unit of comorbidity in SCLC., Conclusion: Patients with advanced SCLC had significantly lower HUS than NSCLC. Both patient cohorts are impacted by symptoms and comorbidity, however, comorbidity had a greater negative effect in SCLC patients.

Objective: Breast cancer is an important public health problem that is increasing in incidence, being a stressor with a negative impact on women's quality of life. This study is focused on the evaluation of temporal precursors (one month before) of women's quality of life undergoing chemotherapy, considering post-surgical personal, clinical, cognitive and neuropsychophysiological factors, according to the Transactional Stress and Coping Model., Methods: This longitudinal study included 112 patients with breast cancer. Data were collected in two different moments: before and during the adjuvant chemotherapy. Structural equation modelling was used to support a theoretically based model in which some antecedent factors impact patients' long-term quality of life through a set of mediators., Results: The associations of breast symptoms, body image and sexual functioning with psychological distress and quality of life were totally mediated by illness perceptions, while the associations of working memory with psychological distress and quality of life were totally mediated by self-efficacy for coping. Patients with greater psychological distress showed higher levels of nadir cortisol., Conclusions: Results showed the importance of assessing patients' perceptions of their illness, prior to chemotherapy, as well as promoting more self-efficacy for coping, in order to improve women's emotional state and quality of life., (© 2020 John Wiley & Sons Ltd.)

Introduction: Due to different social and cultural backgrounds, cervical cancer patients' experience of the treatment process and quality of life after treatment will be different. This study sought to gain in-depth understanding of the experiences of Chinese cervical cancer patients as regards their quality of life and physical symptoms. Methodology: Semi-structured interviews were used to collect data. We recruited 15 women with cervical cancer in eastern China for in-depth interviews. All data were entered into the NVivo 12 software program for analysis. Results: Four themes emerged from the data: (a) uncertainty; (b) physical suffering; (c) psychological pressure; and (d) challenges of marriage and family. Discussion: Cervical cancer patients showed concerns about the disease itself and the physical discomfort it causes, as well as changes in social relations. Health professionals need to talk about these issues and develop strategies to address them accordingly. [ABSTRACT FROM AUTHOR]

We investigated the influence of social determinants of health (SDOH), healthcare services, and health behaviors on mental and physical health outcomes of cancer patients between the first winter and the following post-vaccine summer of the COVID-19 pandemic. A three-wave online survey of individuals diagnosed with incident cancer between January 2019 and January 2020 was conducted between November of 2020 and August of 2021 in northeast Ohio. Descriptive analysis and mixed-effect regression analyses were performed. A total of 322 newly diagnosed cancer patients, with 40 African Americans and 282 Whites (215 from metropolitan areas and 67 nonmetropolitan) responded to the survey questions. In Wave 3 ending in August 2021, the survey respondents reported significantly reduced depression (p =.019) on the Hamilton Depression Rating Scale and improved global health (p =.036) on PROMIS. With age, comorbidity, and other demographic and medical variables controlled in the analyses, the feeling of loneliness (p <.001) and crowded living space (p =.001, p =.015) were the two most prominent factors associated with depression, irritability, and poor global health at baseline, with the lowest p values and persistent effect. Self-efficacy of taking preventive measures was associated with reduced depression (p =.001) and improved global health (p =.029). Increasing access to medicine (p <.01) and satisfaction with telehealth appointments (p <.01) were significantly associated with better global health and reduced irritability. Respondents who had private health insurance reported better health than those that had Medicare coverage only (p <.05). This longitudinal, observational study demonstrated the impact of SDOH on health outcomes of cancer patients. Substandard living conditions resulting in loneliness and crowdedness, quality of medical care (e.g., quality telehealth and access to medicine), and personal behaviors (e.g., self-efficacy) were significantly associated with health outcomes in newly diagnosed cancer patients during the pandemic and should be given adequate consideration for the purpose of improving clinical care. [ABSTRACT FROM AUTHOR]

Background: In 2005, the Institute of Medicine released a report citing the importance of comprehensive treatment summaries or "survivorship plans" for cancer patients completing adjuvant therapy. However, little is known about the best approach or the impact of these interventions on patient well-being. We compared quality of life, treatment satisfaction and cancer impact measures between a minimal or more intensive intervention. Methods: The study was conducted at a single-institution academic breast cancer practice. Women with non-metastatic breast cancer were randomized within six weeks of completing adjuvant therapy (chemotherapy/radiation therapy) to a minimal intervention group (MG) or intensive intervention group (IG). The MG group was given the NCI publication, "Facing Forward: Life after Cancer Treatment" by lay research staff. The intensive group received the same NCI publication; met in person for 1 hour with a nurse practitioner who provided a treatment summary, surveillance and screening recommendations, and information on risk for late effects; and met in person for 1 hour with a nutritionist to review lifestyle recommendations. Subjects were informed that they were in a study of cancer survivors but unaware they were being randomized. The randomization was stratified by ethnicity (Hispanic/non-Hispanic). Both groups completed the 81 -item impact of cancer instrument (IOC), functional assessment of chronic illness therapy-treatment satisfaction-patient satisfaction questionnaire (FACIT-TS-PS) and assessment of survivor concerns (AOC) at baseline, 3 and 6 months. Group t-tests and between group linear regression analyses were performed controlling for ethnicity. Results: Of 140 patients who signed consent, 126 women (66 non-Hispanic, 60 Hispanic) completed baseline questionnaires, 109 completed 3 month, and 109 completed 6 month assessments. The groups were well balanced with regard to age (mean = 54), race, marital status, income and employment status. There were no statistically significant differences between the MG and IG on the 8 domains that comprise the FACIT-TS-PS at 3 and 6 months. The health worry scale of the AOC was lower in the IG (p = 0.006) compared to MG, indicating less health worry and the negative outlook score of the IOC was higher in the MG (p = 0.043) compared to IG at 3 months. At baseline, 3 and 6 months, Hispanic women compared to non-Hispanic women had significantly higher (worse) ACS and IOC health worry (p < 0.001), social life interference (p = 0.01) and meaning of cancer scales (p = 0.0004), but also had greater trust in medical professionals (p = 0.029). Conclusions: We did not observe a difference in most of the IOC or treatment satisfaction scores between the MG and IG interventions at 3 or 6 months, nor did we find any significant change from baseline in either group. However, less health worry and less negative outlook were seen in the IG compared to the MG. At baseline and follow-up, Hispanic women in both interventions compared to non-Hispanic women had more extreme scores on most measures. Despite minimal difference between the interventions, the intensive intervention was more time-consuming and used more health care resources. [ABSTRACT FROM AUTHOR]

Uterine fibroids are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which can range from heavy menstrual bleeding and bulk-related symptoms such as pelvic pressure with bladder and bowel dysfunction to reproductive dysfunction (e.g., infertility or obstetric complications) and pain. The choice of treatment is primarily guided by the type of symptoms in the individual patient and whether they prefer to retain fertility. While hysterectomy provides definitive resolution of fibroid symptoms and remains the most common treatment option, this procedure is invasive with a long recovery window. Radiofrequency ablation (RFA) is now emerging as a uterine preserving and minimally invasive therapy for symptomatic fibroids. Since its introduction, growing evidence for safety and efficacy of RFA has been generated with low rates of complications. This review will discuss RFA for the management of symptomatic uterine fibroids with a special focus on technical approaches, short- and long-term outcomes including fertility outcomes. [ABSTRACT FROM AUTHOR]

AIM: This study aims to evaluate the impact of peripheral neuropathy symptoms throughout with monthly follow-ups during 4 months of paclitaxel treatment. METHODS: This prospective cross-sectional study was conducted with 79 patients. The study population consisted of female patients with breast cancer between August 2018 and January 2019. "Chemotherapy-Induced Peripheral Neuropathy Assessment Tool" and "EORTC C30 Cancer Quality of Life Questionnaire" were applied with four follow-ups. The study was undertaken in accordance with the STROBE checklist for crosssectional studies. RESULTS: The Chemotherapy-Induced Peripheral Neuropathy Assessment Tool except for the general activity subdimension were statistically significant in the ratings of second, compared to first; third compared to first and second; fourth compared to first, second, and third follow-up periods. The overall mean of the EORTC C30 Cancer Quality of Life Questionnaire, functioning, symptom, and global health status were statistically significant in the evaluations of second, compared with first; third compared with first and second; fourth compared with first, second, and third follow-up periods. CONCLUSION: Findings from this study suggest that the increase in neuropathy symptoms during cures negatively affects the quality of life. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the real-world efficacy, safety, and functional outcomes of PRC-063 (multilayer-release methylphenidate) versus lisdexamfetamine (LDX) in ADHD subjects in a phase IV, open-label study. Method: The primary endpoint was the change in the ADHD-DSM-5 Rating Scale (ADHD-5-RS) total score from baseline to Month 4. Secondary endpoints included a non-inferiority comparison between PRC-063 and LDX and measures of functioning and evening behavior. Results: One hundred forty-three pediatric and 112 adult subjects were enrolled. Mean ADHD-5-RS scores (standard deviation) were reduced in pediatric (−16.6 [10.4]) and adult (−14.8 [10.6]) subjects treated with PRC-063 (p <.001). PRC-063 was non-inferior to LDX in the pediatric population but not in the adult population. Significant improvements were demonstrated in quality of life and functionality. Both medications were well-tolerated; more adverse events led to study discontinuation in pediatric subjects treated with LDX versus PRC-063. Conclusion: PRC-063 and LDX significantly improved ADHD symptomatology and functioning and were well-tolerated. [ABSTRACT FROM AUTHOR]

Objectives: Most patients report pain while taking adjuvant endocrine therapy (AET) for the treatment of breast cancer. While studies have examined patients' experiences with side effects, none solely capture patients' experiences with AET‐related pain, a troubling symptom that reduces quality of life and impairs treatment adherence. This study explored themes of AET‐related pain to inform future intervention development. Methods: Between November 2017 and November 2018, female patients (n = 30) with early‐stage breast cancer enrolled between 3 and 36 months post‐initiation of AET. Purposeful sampling was stratified by adherence level, age, distress level and time taking AET. Study staff conducted, transcribed and coded semi‐structured interviews via inductive thematic coding to identify pain‐related themes and achieved high inter‐coded reliability (Kappa = 0.96). Results: Several pain‐related themes were observed. Attitudes around pain are generally negative, and management needs are largely unmet. Patients reported preferences for non‐pharmacological management strategies and cited AET pain as a reason for medication breaks but not discontinuation. Patients within 19 months of starting AET and low adherers reported more intense and disruptive pain. Conclusions: Patients' experiences varied by patient attributes and revealed modifiable factors that may be targeted through behavioural interventions. AET‐related pain is a complex side effect for which psychosocial support may be beneficial. [ABSTRACT FROM AUTHOR]

Objective: The objective was to assess for an association between chemotherapy‐induced peripheral neuropathy (CIPN) onset and development of depression and anxiety in breast cancer (BrCa) survivors. Methods: A retrospective observational cohort was used and identified from Optum's De‐identified Clinformatics® Data Mart Database years 2012–2015. Three groups of women were derived based on BrCa and CIPN status: BrCa+/CIPN+ (n = 244), BrCa+/CIPN− (n = 8870), and BrCa−/CIPN− (n = 1,125,711). The ratio of the prevalence ratios (RPR) determined if the change in risk of depression and anxiety from the 12‐month preindex period to postindex period I (0–6 months) and II (7–12 months) was different for BrCa+/CIPN+ compared to BrCa+/CIPN− and BrCa−/CIPN−. Results: The adjusted RPR for depression was significantly elevated for BrCa+/CIPN+ compared to BrCa+/CIPN− and BrCa−/CIPN− for postindex periods I (RPR = 1.35 [1.10,1.65] and 1.33 [1.08,1.63], respectively) and II (RPR = 1.53 [1.21,1.94] and 1.50 [1.17,1.93], respectively). The RPR for anxiety was significantly elevated for BrCa+/CIPN+ compared to BrCa+/CIPN− and BrCa−/CIPN− for postindex periods I (RPR = 1.37 [1.12,1.67] and 1.31 [1.06,1.61], respectively) and II (RPR = 1.41 [1.13,1.76] and 1.28 [1.02,1.62], respectively). Conclusions: Among BrCa survivors, CIPN onset is associated with a subsequent increased 12‐month risk of depression and anxiety. Depression and anxiety screening should be considered in BrCa+/CIPN+ survivors, particularly given their known impact on fall risk. The observed association between CIPN and an increased risk of depression and anxiety should be further studied in prospective studies. [ABSTRACT FROM AUTHOR]

Objective: This study aims to co‐design an evidence‐ and theory‐based behavioural intervention to reduce the impact of chemotherapy‐induced peripheral neuropathy (CIPN) symptoms on patients' quality of life. Methods: Guided by the Medical Research Council Framework for developing and evaluating complex interventions, our intervention development process was guided by (a) findings of systematic reviews, (b) inductive analysis of 39 h of observational fieldwork, 12 patient and 11 clinician interviews, (c) deductive analysis using the Common‐Sense Model to develop a Self‐Regulation Model of CIPN and (d) 17 patients and 18 clinicians co‐designing the intervention. Results: CIPN perception and coping behaviours were highlighted as processes to target when co‐designing an intervention. The processes targeted in our intervention are CIPN perception and coping behaviours, namely, (a) self‐monitoring of symptoms, (b) communicating and early reporting of symptoms to clinicians, (c) participating in making chemotherapy dose reduction decisions with their clinicians and (d) engaging in self‐management and safety strategies to reduce impact of CIPN symptoms. To address these, a behavioural intervention was deemed suitable. Conclusion: We developed a self‐regulation model of CIPN and a logic model for documenting the proposed mechanism of action of our co‐designed behavioural intervention for reducing impact of CIPN symptoms. [ABSTRACT FROM AUTHOR]

Objective. To assess the efficacy of mecobalamin tablets combined with troxerutin in the treatment of nonsmall cell lung cancer (NSCLC) chemotherapy-induced peripheral neuropathy (CIPN). Methods. From January 2020 to December 2021, 120 NSCLC patients with CIPN treated in our institution meeting the inclusion criteria were enrolled and assigned to receive mecobalamin tablets treatment in the control group, or assigned to receive mecobalamin tablets combined with troxerutin treatment in the research group, with 60 patients in each group. All patients were evaluated for clinical efficacy, neuropathic score, patient-reported CIPN symptoms, neuropathic pain grade, and quality of life after 3 weeks of treatment. Results. The clinical treatment effective rate of the patients in the research group was significantly higher than that of the patients in the control group (81.7% vs. 58.3%, P < 0.05). Compared with before treatment, neuropathic score, numbness and tingling score, hot/coldness in hands/feet score, and peripheral neurotoxicity grade in all patients decreased significantly after treatment (P < 0.05). And these reductions were more considerable in the research group compared to the control group (P < 0.05). In addition, the quality of life scores (EORTC QLQ-C30) increased significantly in all patients after treatment, and this rise was more considerable in the research group compared to the control group (P < 0.05). Conclusion. Mecobalamin tablets combined with troxerutin in the treatment of NSCLC patients with CIPN is effective and safe, and can significantly improve the symptoms and quality of life of NSCLC patients with CIPN. [ABSTRACT FROM AUTHOR]

A cancer diagnosis can have significant financial impacts for patients, often resulting from unexpected out‐of‐pocket expenses and a reduced capacity to work. These financial implications have been well characterised quantitatively in common cancers. However, less is known about the lived experience of financial stress, particularly outside the United States and in rarer cancers. This study aimed to explore the perceived financial impact of acute myeloid leukaemia (AML)—a rare haematological malignancy where patients may be particularly vulnerable to financial stress due to the lengthy, specialised and centralised care. The findings provide insight into the patients' lived experience of the personal financial impact of the disease. This Australian qualitative study was undertaken with 11 adults in remission from AML and recruited from their treating hospital. Semi‐structured interviews were transcribed, and data were managed using NVivo. Themes were identified through inductive and deductive analysis using open, axial and thematic coding. Four themes were identified: burden of AML‐attributable costs (e.g. out‐of‐pocket parking and medication expenses); accommodating the AML‐impact on paid work (e.g. early retirement and modifying job tasks); the consequence of financial strain from AML (e.g. using savings and accessing Government welfare) and concerns about the future and future familial financial burden (e.g. securing finances and worry about depleting financial resources). A reduction in or stopping work was perceived as the most burdensome to their current and future finances. The findings demonstrate people with AML experience financial difficulty even within a publically funded healthcare system. Opportunities exist for health services to alleviate some financial burden through reducing or abolishing parking fees for oncology patients and ensuring adequate access to social workers to facilitate access to Government welfare. Improving patients' financial difficulties contributes to improved quality of life, which is congruent to cancer survivorship. [ABSTRACT FROM AUTHOR]

Simple Summary: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication due to treatment with anti-cancer agents. Our aim was therefore to assess the non-inferiority of the analgesic effect and safety of tapentadol alone compared to duloxetine plus tapentadol administered to patients with chemotherapy-induced peripheral neuropathy. The use of tapentadol is a safe and effective analgesic therapy in patients with CIPN. Positive effects of tapentadol were noted on the patients' quality-of-life assessments. Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication due to treatment with many commonly used anti-cancer agents. CIPN is a mainly sensory neuropathy that can be characterized by the appearance of motor and autonomic alterations. Clinicians may offer duloxetine (DLX) for patients with cancer experiencing CIPN. Our aim was to assess the non-inferiority of the analgesic effect and safety of tapentadol (TP) alone compared to duloxetine plus tapentadol administered to patients with CIPN. Methods: A total of 114 patients were enrolled in the study and randomized to receive tapentadol in a dosage of 50 to 500 mg/day (n = 56) or tapentadol plus duloxetine in a dosage of 60 to 120 mg/day (n = 58) for a period of 4 weeks. We evaluated the analgesia efficacy, defined as a decrease in pain on the NRS between the first administration and 28 days later. Secondary endpoints included analgesia efficacy at 28 and 42 days, defined by a decrease in DN4 and LEPs, decrease in quality of life, and the incidence of any serious or non-serious adverse events after the first administration. Results: In this randomized, double-blind trial comparing TP and TP plus DLX for CIPN management, TP was feasible and non-inferior to the association with DLX as far as the reduction of pain after chemotherapy at 28 days is concerned. Scores on other rating scales evaluating the quality of life, anxiety and depression, and the characteristics of pain revealed similar improvements associated with tapentadol versus duloxetine at these time points. Conclusion: The use of TP is a safe and effective analgesic therapy in patients with CIPN. Positive effects of TP were noted on the patients' quality-of-life assessments. [ABSTRACT FROM AUTHOR]

Introduction: Regular physical activity (PA) can be beneficial to breast cancer survivors, although the majority do not devote sufficient time to the practice. The long-term side effects of cancer treatment represent barriers to adopting healthy lifestyle habits. Goal: Identify factors that influence the intention to practise regular PA among breast cancer survivors. Methodology: A correlational study was conducted among my Active Health (Ma Santé Active) program participants (N = 136), using a self-administered questionnaire based on the theory of planned behaviour. Findings: Multiple regression analysis shows that attitude, perceived control, behavioural beliefs and control beliefs are the determinants of intention. Discussion and conclusion: It is recommended to design interventions based on these determinants to strengthen the behavioural intention of breast cancer survivors. The paper will also inform healthcare professionals about the intervention targets to be utilized to motivate women with a breast cancer diagnosis to engage in regular PA. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced peripheral neuropathy (CIPN) refers to numbness, tingling, and burning sensation caused by chemotherapy that can cause impairment in Quality of Life (QoL) of the patients. Study assesses severity, risk factors, and quality of life of patients associated with CIPN. A cross sectional descriptive study was conducted at day care ward, tertiary care hospital India. Total of 98 patients receiving paclitaxel for ≥4 months were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, CIPN severity, risk factors, and QoL were collected by structured questionnaires. Study revealed that median score of autonomic symptoms was higher than sensory and motor symptoms. Mean score of FACT/GOG-Ntx sub-domain was 99.05 ± 20.87on a scale of 0 to 152. ECOG Performance status, current exercise behavior, and fruit and vegetable intake was found to be significantly (at p <.05) associated with sensory, motor, and autonomic symptom score. Therefore, CIPN was found to have debilitating effect on QoL. [ABSTRACT FROM AUTHOR]

To identify symptom burden profiles among men with advanced prostate cancer undergoing androgen-deprivation therapy and examine their association with baseline sociodemographic and medical characteristics and psychosocial outcomes over time. Latent profile analysis was employed to identify distinct groups based on the Expanded Prostate Index Composite and the McGill Pain Questionnaire at baseline. Psychosocial outcomes were assessed at baseline, 6- and 12-month follow-ups. Three profiles emerged: "high symptom burden," "high sexual bother," and "low symptom burden." Men with "high symptom burden" were younger and exhibited higher baseline levels of depression, stress, cancer-specific distress, and anxiety than men in the other two groups. However, men with "high symptom burden" also demonstrated improvement in these psychosocial outcomes over time. Men with advanced prostate cancer who experience multiple co-occurring symptoms demonstrate worse psychosocial adjustment. Patients with substantial symptom burden, and specifically young men, may benefit from prompt referral to supportive care services. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced peripheral neuropathy (CIPN) can be considered a phantom pain because the sensations of CIPN have no concurrent input into the nervous system. In fact, the damage that is done to the peripheral nerves is, as we know to date, irreversible. There are limited data supporting the use of neuromodulatory techniques to treat CIPN and no trials with aims for prevention. The objective of this article is to review current research on neurofeedback to treat CIPN. [ABSTRACT FROM AUTHOR]

The double burden of cancer and financial hardship may provoke an existential crisis for many people, as both physical and economic survival are threatened. There is ample evidence of the harmful impact of cancer-related financial stress, also known as financial toxicity, on quality of life. A separate body of literature exists for the positive effects of meaning-focused coping and meaning-making interventions on emotional well-being in people with cancer. However, there is a lack of research into the potential relationship between meaning-making and the ability to cope with cancer-related financial hardship. The present paper identifies findings from a pilot study whose purpose was to explore possible connections between financial toxicity and patients' ability to make or find meaning in their lives. A typology of coping emerged from qualitative focus group data that highlighted the co-existence of the meaning-making process with both cancer and financial stress. [ABSTRACT FROM AUTHOR]

Objective: Over recent decades, supportive care and patient quality of life, advocated by dedicated guidelines, have become a core focus of the concept of integrative medicine. The Calista 2 survey was conducted in France between September 2016 and October 2017 among oncologists and their patients being treated for early breast cancer, adjuvant colorectal cancer or advanced lung cancer. The present analysis sought to ascertain, understand and rank the expectations of cancer patients with regard to supportive care. Methods: Data were collected from 467 questionnaires from patients recruited by 82 oncologists. Inclusion criteria were patients already on treatment for breast cancer, colorectal cancer or lung cancer. Most supportive care facilities were available at the point of care. Results: Physicians were mainly seen to offer management of adverse events (81%), and pain (72%), psychological support (56%), and advice on diet/nutrition (49%). Patient uptake of supportive care related essentially to management of adverse events (72%) and pain (61%), diet/nutrition (34%), and self‐image improvement techniques (31%). The main unmet needs voiced by patients were information on complementary medicines (28%), management of fatigue (27%), and relaxation techniques (24%). Conclusion: Supportive care was essentially seen to satisfy patient requirements with regard to the management of adverse events and pain. However, patients highlighted the need for a wider access to fatigue management and information on complementary medicine and relaxation techniques. [ABSTRACT FROM AUTHOR]

Background. Pretreatment health-related quality of life (HRQOL) is associated with survival outcome in lung cancer patients. There is a lack of systematic research on pretreatment HRQOL in lung cancer patients who receive integrative oncology (IO). We evaluated patient-reported outcomes in these patients at time of diagnosis at a certified oncology and lung cancer centre. Methods. The present analysis is a prospective real-world data study. Clinical and demographic data were obtained from the accredited Network Oncology cancer registry. Pretreatment HRQOL was evaluated (international standardized questionnaires) for people with all-stage lung cancer at first diagnosis that received IO consisting of standard therapy and multimodal add-on complementary concepts. Univariate and adjusted multivariate regression analyses were performed with R. Results. Eighty seven patients with all-stage lung cancer were eligible for the questionnaire analysis (median age 68.0 years, IQR 59.0–74.4). Thirty percent of the total cohort reported financial difficulties. Self-reported pretreatment financial difficulty was associated with younger age (p = 0.007), pretreatment pain (p = 0.006), anxiety (p = 0.04), and low mood (p = 0.03). Pain (p = 0.03) and young age (p = 0.02) in the early- and late-stage lung cancer were associated with financial difficulties. Conclusion. We suggest physicians screen lung cancer patients at working age (broadly aged ≤65 years) and/or who report increased pain at the time of diagnosis as they might be at particular risk for emotional, physical, and financial problems. Our results emphasize to address emotional and physical needs before and during early treatment in lung cancer patients as suggested in integrative and supportive cancer concepts. [ABSTRACT FROM AUTHOR]

Background: Education and counselling are widely used independently or as supplementary components in the psychosocial interventions. However, there is a certain level of ambiguity if used separately. In this analysis, we attempted to answer the following question; “Does the education and counseling support improve of the adjustment to cancer in women diagnosed with breast cancer?” Methods: An online search was undertaken in 12 databases for the longitudinal studies for the period from January 2007 to March 2018. The effects of the interventions on the adjustment to breast cancer, were calculated based on the results of the mental adjustment and quality of life (QoL). Three distinct periods were examined; baseline, three months, and six months. The methodological quality, risk of bias, publication bias, and attrition rate were examined. Meta-analysis was carried out using Review Manager 5.3 with the results graphically presented. Results: A comprehensive systematic review was conducted for 5,464 titles, of which 22 studies fulfilled the inclusion criteria, however 14 studies completed the data and included in the qualitative synthesis; included 3,419 patients. The mean of overall attrition rate in both groups was 14.37% (SE= 2.87, median= 12.28). In mental adjustment, the total mean differences for the three trials were statistically significant 0.40 (0.24 to 0.57). For the QoL, the mean differences of the three trials were statistically non-significant 0.18 (-0.48 to 0.84). Conclusion: The educational and/or counseling interventions can be beneficial and useful for patients to adapt with the breast cancer, however, it is less effective on the QoL. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced neuropathic pain (CINP) is one of the most severe side effects of anticancer agents, such as platinum- and taxanes-derived drugs (oxaliplatin, cisplatin, carboplatin and paclitaxel). CINP may even be a factor of interruption of treatment and consequently increasing the risk of death. Besides that, it is important to take into consideration that the incidence of cancer is increasing worldwide, including colorectal, gastric, lung, cervical, ovary and breast cancers, all treated with the aforementioned drugs, justifying the concern of the medical community about the patient's quality of life. Several physiopathological mechanisms have already been described for CINP, such as changes in axonal transport, mitochondrial damage, increased ion channel activity and inflammation in the central nervous system (CNS). Another less frequent event that may occur after chemotherapy, particularly under oxaliplatin treatment, is the central neurotoxicity leading to disorders such as mental confusion, catatonia, hyporeflexia, etc. To date, no pharmacological therapy has shown satisfactory effect in these cases. In this scenario, duloxetine is the only drug currently in clinical use. Peroxisome proliferator-activated receptors (PPARs) belong to the class of nuclear receptors and are present in several tissues, mainly participating in lipid and glucose metabolism and inflammatory response. There are three PPAR isoforms: α, β/δ and γ. PPARγ, the protagonist of this review, is expressed in adipose tissue, large intestine, spleen and neutrophils. This subtype also plays important role in energy balance, lipid biosynthesis and adipogenesis. The effects of PPARγ agonists, known for their positive activity on type II diabetes mellitus, have been explored and present promising effects in the control of neuropathic pain, including CINP, and also cancer. This review focuses largely on the mechanisms involved in chemotherapy-induced neuropathy and the effects of the activation of PPARγ to treat CINP. It is the aim of this review to help understanding and developing novel CINP therapeutic strategies integrating PPARγ signalling. [ABSTRACT FROM AUTHOR]

Background. Chemotherapy-induced peripheral neuropathy (CIPN) remains as a big unsolved challenge for cancer patients and oncologists. However, there is no effective treatment to prevent and cure it. This systematic review and meta-analysis chiefly aimed to assess the effectiveness and safety on the method of activating blood and dredging collaterals in traditional Chinese medicine (TCM) for reducing CIPN. Methods. Two authors comprehensively searched all the randomized controlled trials (RCTs) via PubMed, Cochrane, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD). The Review Manager (RevMan) 5.0 was used to conduct the meta-analysis. Results. 20 trials including 1481 participants were analyzed. 15 trials tested the incidence of all-grade CIPN which was significantly lower in intervention arm and 16 trails presented that the result of high-grade CIPN was the same. The total effective rate of the use of Chinese herbs was 77.19% versus 45.79% in the comparator group. Besides, the use of Chinese herbs statistically promoted the sensory nerve conduction velocity (SNCV) and the motor nerve conduction velocity (MNCV). Besides, the quality of life (QoL) in the intervention group was better than the comparator one. Herbs-related adverse events were skin allergy, skin chap, and scald, which could be managed well. Conclusions. The work involving studies of the effectiveness and safety on TCM for reducing CIPN proves to be encouraging. Herbs with the function of activating blood and dredging collaterals were found to potentially promote the curative effects as well as making improvements of SNCV and MNCV. However, in the future, more double-blind, multicenter, large-scale RCTs and more comprehensive researches are still required. [ABSTRACT FROM AUTHOR]

Objectives. Some chemotherapy drugs can damage the nerves and cause peripheral neuropathy which is accompanied by severe neuropathic pain or gait impairment. The purpose of this study was to assess the feasibility and the safety of acupuncture for the treatment of peripheral neuropathy following chemotherapy in Korean breast cancer patients. Design. This study was a prospective single-arm observational study using before and after measurements in breast cancer patients presenting with taxane-induced peripheral neuropathy. Settings/Location. This study was performed at East-West Medical Center at Daegu Catholic University Hospital, Daegu, South Korea. Interventions. Acupuncture was administered 3 times a week for 4 consecutive weeks, for 25 ± 5 minutes at each session. Outcome Measures. The primary outcome measure was severity of CIPN using the Neuropathic Pain Symptom Inventory (NPSI) assessed by a self-administered questionnaire and Nerve Conduction Study (NCS) of extremities. The secondary outcome measure was quality of life (QoL) assessed by a self-administered questionnaire using the 36-Item Short From Health Survey (SF-36). Results. Acupuncture significantly reduced the severity of CIPN assessed by NPSI score. Four weeks after the last treatment, the symptoms were not aggravated. According to NCS, 42.9% of participants showed improvement of sensory neuropathy. At the end of the treatment, SF-36 scores were significantly increased for variables including physical functioning, role limitations due to physical health problems, social functioning, and general health perceptions compared to those of baseline measurement. Conclusions. Acupuncture improved symptoms of CIPN and QoL in Korean women suffering from peripheral neuropathy after chemotherapy using taxane for breast cancer. The effects of acupuncture lasted for at least 1 month after the treatment. [ABSTRACT FROM AUTHOR]

Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients’ quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO. [ABSTRACT FROM AUTHOR]

Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods. A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians (P≤0.05). Conclusion. With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints. [ABSTRACT FROM AUTHOR]

Objectives: Tamoxifen non-adherence is apparent in up to half of breast cancer survivors and is associated with increased risk of recurrence and reduced quality of life. However, factors contributing to non-adherence in this population are currently poorly understood. This study explored the relationship between key components of the Common Sense Model of Illness Representations (CSM)/the Theory of Planned Behaviour (TPB) and intentional and unintentional non-adherence in a large sample of women prescribed tamoxifen following primary breast cancer.Design: Cross-sectional questionnaire study (n = 777).Methods: Women were eligible if they were over 18, had been diagnosed with primary breast cancer, and had been prescribed tamoxifen. Participants were recruited in clinic or online and completed questionnaires assessing illness perceptions, treatment beliefs, adherence, quality of life, social support, distress, and the key TPB components. Logistic regressions were conducted to test elements from each model and to identify correlates of intentional and unintentional non-adherence.Results: Patients were classified as non-adherent based on Medication Adherence Rating Scale scores; 44% of the population were non-adherent; 41% reported unintentional non-adherence, and 9% reported intentional non-adherence. Study variables accounted for more variance in intentional (Nagelkerke R2  = 46%) than unintentional non-adherence (Nagelkerke R2  = 17%). Intentional non-adherence was best explained by a combination of TPB and CSM variables, but these variables did not contribute significantly to unintentional non-adherence.Conclusions: The TPB and the CSM provide a useful framework for understanding intentional tamoxifen non-adherence. Elements from both models should be considered when designing interventions to increase adherence rates. Statement of contribution What is already known about this subject? Non-adherence to tamoxifen is common and is associated with poor clinical outcomes. Few modifiable predictors of tamoxifen non-adherence have been identified. What does this study add? Unintentional non-adherence is reported much more frequently than intentional non-adherence. Elements from the CSM and TPB provide a useful framework for understanding non-adherence to tamoxifen. Unique correlates were found for intentional and unintentional non-adherence. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the scale structure and psychometrics of the EORTC chemotherapy-induced peripheral neuropathy module (QLQ-CIPN20).Methods: Using confirmatory factor analyses (CFA), we tested two hypothesized scale structure models of the QLQ-CIPN20 in 473 patients with non-small cell lung cancer, 281 patients with heterogeneous cancer diagnoses, and 500 patients with colorectal cancer. We also modeled the two hypothesized models as bi-factor models. These included a general factor, in addition to the specific domain factors. Additional models were investigated with exploratory factor analysis (EFA). Known groups validity was evaluated where justified.Results: CFA could not confirm the two hypothesized models (Model 1: CFI < 0.926; TLI < 0.914; RMSEA > 0.077 and Model 2: CFI < 0.906; TLI < 0.887; RMSEA > 0.105) in any of the three samples. Including a general factor to these two hypothesized models to produce a bi-factor model also did not yield satisfactory results. Using EFA, we identified four different factor structures in the three samples that were unstable due to cross loadings of the items. When scoring the QLQ-CIPN20 as a simple, additive checklist evidence was found for known groups validity in the first two samples based on Common Toxicity Criteria (CTC-AE), and in the third sample based on exposure to CIPN-inducing chemotherapy.Conclusions: Neither CFA nor EFA yielded support for a stable subscale structure for the QLQ-CIPN20. Scoring the questionnaire as a simple additive checklist results in acceptable validity. [ABSTRACT FROM AUTHOR]

Purpose: To describe the prevalence, severity, and risk factors of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on function and quality of life (QOL) among women treated for breast cancer in a large U.S. Community Oncology practice.Methods: Women previously treated with taxane-based chemotherapy for early-stage breast cancer completed the EORTC QLQ-C30, QLQ-BR23, and QLQ-CIPN20. Subscales are scored 0-100; higher scores indicate greater symptom severity. Pre-specified hypotheses were tested.Results: 126 women with mean age 56.7 years (SD 11.8) were stage I-II (79.4%) or stage III (20.6%) at the time of the survey; 65.1% were White and 27.8% were Black or African American. The mean time since last taxane chemotherapy cycle was 144.9 weeks (SD 112.9). 73.0% reported having CIPN. QLQ-CIPN20 mean scores for the sensory, motor, and autonomic subscales were 18.9 (SD 23.1), 18.6 (SD 18.7), and 17.1 (SD 21.8), respectively. CIPN symptom severity was negatively correlated with global health status/QOL and physical and role functioning (range of r = -0.46 to -0.72). It was not associated with age, body mass index, diabetes, or cumulative taxane dosage, but was greater for Black or African American women (e.g., sensory, p < 0.002). CIPN sensory impairment was marginally greater for patients treated with paclitaxel compared to docetaxel (p < 0.064).Conclusions: CIPN was prevalent in this community oncology practice and significantly impacts function and QOL. These data highlight the importance of developing methods to mitigate CIPN, and for screening for CIPN particularly among Black or African American women. [ABSTRACT FROM AUTHOR]

Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients’ reporting of side effects is unknown. We undertook this study to assess factors associated with women’s reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01–69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence. [ABSTRACT FROM PUBLISHER]

Molecularly targeted anti-cancer therapies have revolutionized cancer treatment by improving both quality of life and survival in cancer patients. However, many of these drugs are associated with cardiovascular toxicities that are sometimes dose-limiting. Moreover, the long-term cardiovascular consequences of these drugs, some of which are used chronically, are not yet known. Although the scope and mechanisms of the cardiac toxicities are better defined, the mechanisms for vascular toxicities are only beginning to be elucidated. This review summarizes what is known about the vascular adverse events associated with three classes of novel anti-cancer therapies: vascular endothelial growth factor (VEGF) inhibitors, breakpoint cluster-Abelson (BCR-ABL) kinase inhibitors used to treat chronic myelogenous leukaemia (CML) and immunomodulatory agents (IMiDs) used in myeloma therapeutics. Three of the best described vascular toxicities are reviewed including hypertension, increased risk of acute cardiovascular ischaemic events and arteriovenous thrombosis. The available data regarding the mechanism by which each therapy causes vascular complication are summarized. When data are limited, potential mechanisms are inferred from the known effects of inhibiting each target on vascular cell function and disease. Enhanced understanding of the molecular mechanisms of vascular side effects of targeted cancer therapy is necessary to effectively manage cancer patients and to design safer targeted cancer therapies for the future. [ABSTRACT FROM AUTHOR]

Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors’ quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed. [ABSTRACT FROM PUBLISHER]

The article focuses on a randomized control trial on the cost-effectiveness of the Mindful-Based Stress Reduction (MBSR) program for breast cancer survivors. It mentions the psychological and physiological effects of curative cancer treatments that can reduce health-related quality of life (HRQOL), some common symptoms among breast cancer survivors including anxiety, fatigue and muscle ache, and finding showing the program results into improved HRQOL among cancer survivors at a low cost.

Introduction: Few studies have evaluated interventions to improve quality of life (QOL) for Latina breast cancer survivors and caregivers. Following best practices in community-based participatory research (CBPR), we established a multi-level partnership among Latina survivors, caregivers, community-based organizations (CBOs), clinicians, and researchers to evaluate a survivor-caregiver QOL intervention. Methods: A CBO in the mid-Atlantic region, Nueva Vida, developed a patient-caregiver program called Cuidando a mis Cuidadores (Caring for My Caregivers), to improve outcomes important to Latina cancer survivors and their families. Together with an academic partner, Nueva Vida and three CBOs established a multi-level team of researchers, clinicians, Latina cancer survivors, and caregivers to conduct a national randomized trial to compare the patient-caregiver program to usual care. Results: Incorporating team feedback and programmatic considerations, we adapted the prior patient-caregiver program into an 8-session patient- and caregiver-centered intervention that includes skill-building workshops such as managing stress, communication, self-care, social well-being, and impact of cancer on sexual intimacy. We will measure QOL domains with the patient-reported outcomes measurement information system, dyadic communication between the survivor and caregiver, and survivors' adherence to recommended cancer care. To integrate the intervention within each CBO, we conducted interactive training on the protection of human subjects, qualitative interviewing, and intervention delivery. Conclusion: The development and engagement process for our QOL intervention study is innovative because it is both informed by and directly impacts underserved Latina survivors and caregivers. The CBPR-based process demonstrates successful multi-level patient engagement through collaboration among researchers, clinicians, community partners, survivors, and caregivers. [ABSTRACT FROM AUTHOR]

This study aims to determine the psychosocial correlates of self-reported adherence to cancer treatment appointments and treatment delays and interruptions. The sample included 622 immigrant cancer patients from New York City. Patients completed a survey that included sociodemographic and health-related questions, questions assessing missed appointments and delays/or interruptions, and quality of life and depression scales. After controlling for sociodemographic characteristics, having a positive depression screen and poor physical and emotional well-being were significant predictors of missed appointments and delays and/or interruptions of treatment. Non-adherence to treatment appointments in immigrant cancer patients is a complex outcome related to important modifiable or treatable factors. [ABSTRACT FROM PUBLISHER]

In this study, we aimed to assess the safety and efficacy of physical exercise, with or without whole-body vibration (WBV), in patients with aromatase inhibitor-induced musculoskeletal symptoms (AIMSS). Eligible patients were adults (≥18 years) with a history of breast cancer and current AIMSS. Enrolled patients (n = 22) were randomly assigned 1:1 to receive physical exercise combined with WBV or sham WBV for 4 weeks. The primary endpoint was pain intensity measured by numerical pain rating scale (NPRS). The secondary endpoints were muscle strength, physical function, physical performance, and quality of life. The WBV group (mean age: 51.73 ± 10.73 years; body mass index (BMI): 25.56 ± 5.17 kg/m2) showed a statistically significant pain reduction (NPRS: 6.82 ± 1.17 vs. 5.73 ± 1.01; p = 0.031), whereas patients in the sham WBV group (mean age: 58.55 ± 9.71 years; BMI: 27.31 ± 3.84 kg/m2), did not reach statistical significance (NPRS: 6.91 ± 2.02 vs. 5.91 ± 2.51; p = 0.07). Concurrently, muscle strength, physical performance, and quality of life significantly improved in both groups, without significant differences between groups. No dropouts and no side effects were recorded. Both patients and the physical therapist reported a high level of satisfaction with the intervention. Our findings suggest that physical exercise and WBV combination might be a safe therapeutic option for improving the rehabilitative management of patients with AIMSS. [ABSTRACT FROM AUTHOR]

Background: COVID-19 represents a threat both for the physical and psychological health of oncological patients experiencing heightened distress levels to which the fear of the virus is also added. Moreover, fear of COVID-19 could lead oncological patients to experience feelings of hopelessness related to their medical care. Patient-centered communication may act as a buffer against the aforementioned variables. This study aimed to test the role of doctor–patient communication in the relationship between fear of COVID-19 and hopelessness. Methods: During the COVID-19 pandemic, a sample of 90 oncological outpatients was recruited (40 males (44.4%) and 50 females (55.6%), mean age = 66.08 (SD = 12.12)). A structured interview was developed and used during the pandemic to measure the patients' perceived (A) fear of COVID-19, and (B) feelings of hopelessness, and (C) physicians' use of empathetic and (D) clear language during the consultation. A multiple mediation model was tested, and the effects between males and females were also compared. Results: Empathetic and clear doctor–patient communication buffered the adverse effect of the fear of COVID-19 on hopelessness through a full-mediation model. The effects did not differ between males and females in the overall model but its indirect effects. Discussions: Patient-centered communication using empathy and clear language can buffer the adverse effect of the fear of COVID-19 and protect oncological patients from hopelessness during the pandemic. These findings might help to improve clinical oncological practice. [ABSTRACT FROM AUTHOR]

Simple Summary: Adjuvant treatment of stage III/IV melanoma patients with immune-checkpoint inhibition or targeted therapy can significantly improve recurrence-free survival. However, it is unknown how many patients with an indication for adjuvant therapy do indeed choose to receive it and what the reasons for declining are. In patients with a BRAF mutation, it is not known whether more patients prefer targeted or immunotherapy. This study investigates the real-world situation of 904 patients from 13 German Dermatologic Cooperative Oncology Group skin cancer centers with an indication for adjuvant treatment since the approval of the corresponding drugs as adjuvant treatment. Aims of this study were to investigate the patient groups who opt for or against adjuvant treatment, respectively targeted or immunotherapy, and the reasons for refusal. Findings of this study show the current acceptance and choice of adjuvant melanoma treatment and may support patients and physicians in the therapy decision-making process. Adjuvant treatment of melanoma patients with immune-checkpoint inhibition (ICI) and targeted therapy (TT) significantly improved recurrence-free survival. This study investigates the real-world situation of 904 patients from 13 German skin cancer centers with an indication for adjuvant treatment since the approval of adjuvant ICI and TT. From adjusted log-binomial regression models, we estimated relative risks for associations between various influence factors and treatment decisions (adjuvant therapy yes/no, TT vs. ICI in BRAF mutant patients). Of these patients, 76.9% (95% CI 74–80) opted for a systemic adjuvant treatment. The probability of starting an adjuvant treatment was 26% lower in patients >65 years (RR 0.74, 95% CI 68–80). The most common reasons against adjuvant treatment given by patients were age (29.4%, 95% CI 24–38), and fear of adverse events (21.1%, 95% CI 16–28) and impaired quality of life (11.9%, 95% CI 7–16). Of all BRAF-mutated patients who opted for adjuvant treatment, 52.9% (95% CI 47–59) decided for ICI. Treatment decision for TT or ICI was barely associated with age, gender and tumor stage, but with comorbidities and affiliated center. Shortly after their approval, adjuvant treatments have been well accepted by physicians and patients. Age plays a decisive role in the decision for adjuvant treatment, while pre-existing autoimmune disease and regional differences influence the choice between TT or ICI. [ABSTRACT FROM AUTHOR]

Bortezomib is a pivotal drug for the management of multiple myeloma. However, bortezomib is a neurotoxic anticancer drug responsible for chemotherapy-induced peripheral neuropathy (CIPN). CIPN is associated with psychological distress and a decrease of health-related quality of life (HRQoL), but little is known regarding bortezomib-related CIPN. This single center, cross-sectional study assessed the prevalence and severity of sensory/motor CIPN, neuropathic pain and ongoing pain medications, anxiety, depression, and HRQoL, in multiple myeloma patients after the end of bortezomib treatment. Paper questionnaires were sent to patients to record the scores of sensory and motor CIPNs (QLQ-CIPN20), neuropathic pain (visual analogue scale and DN4 interview), anxiety and depression (HADS), the scores of HRQoL (QLQ-C30 and QLQ-MY20) and ongoing pain medications. Oncological data were recorded using chemotherapy prescription software and patient medical records. The prevalence of sensory CIPN was 26.9% (95% CI 16.7; 39.1) among the 67 patients analyzed and for a mean time of 2.9 ± 2.8 years since the last bortezomib administration. The proportion of sensory CIPN was higher among patients treated by intravenous and subcutaneous routes than intravenous or subcutaneous routes (p = 0.003). QLQ-CIPN20 motor scores were higher for patients with a sensory CIPN than those without (p < 0.001) and were correlated with the duration of treatment and the cumulative dose of bortezomib (coefficient: 0.31 and 0.24, p = 0.01 and 0.0475, respectively), but not sensory scores. Neuropathic pain was screened in 44.4% of patients with sensory CIPN and 66.7% of them had ongoing pain medications, but none were treated with duloxetine (recommended drug). Multivariable analysis revealed that thalidomide treatment (odds-ratio: 6.7, 95% CI 1.3; 35.5, p = 0.03) and both routes of bortezomib administration (odds-ratio: 13.4, 95% CI 1.3; 139.1, p = 0.03) were associated with sensory CIPN. Sensory and motor CIPNs were associated with anxiety, depression, and deterioration of HRQoL. Sensory CIPN was identified in a quarter of patients after bortezomib treatment and associated with psychological distress that was far from being treated optimally. There is a need to improve the management of patients with CIPN, which may include better training of oncologists regarding its diagnosis and pharmacological treatment. [ABSTRACT FROM AUTHOR]

Tetrodotoxin (TTX) has emerged as a potentially efficacious agent for chemotherapy-induced neuropathic pain (CINP), a prevalent, debilitating condition often resistant to analgesics. This randomized, double-blind, dose-finding study was undertaken to explore safety and trends in efficacy of four TTX doses and to identify a dose for further study. One hundred and twenty-five patients with taxane- or platinum-related CINP received subcutaneous placebo or TTX (7.5 µg twice daily (BID), 15 µg BID, 30 µg once daily (QD), 30 µg BID) for four consecutive days. Primary outcome measure was average patient-reported Numeric Pain Rating Scale (NPRS) score during Days 21–28 post-treatment. Changes in mean NPRS score were not statistically different between cohorts, due to small trial size and influence of a few robust placebo responders. Cumulative responder analysis showed significant difference from placebo with 30 µg BID cohort using the maximum response at any timepoint (p = 0.072), 5-day (p = 0.059), 10-day (p = 0.027), and 20-day (p = 0.071) rolling averages. In secondary quality of life (QOL) outcomes, 30 µg BID cohort also differed significantly from placebo in a number of SF-36 and CIPN20 subscales. Most adverse events (AE) were mild or moderate with oral paresthesia (29.6%) and oral hypoesthesia (24.8%) as most common. [ABSTRACT FROM AUTHOR]

This cross-sectional study examines the relationship of polypharmacy to health-related quality of life (HRQoL) among a group of older American Indians. An in-home interview and survey were administered to 63 community-dwelling American Indians aged 50 or older who were taking four or more prescription medications regularly. With the component summary scores from the Medical Outcomes Study Short Form-36 instrument analyzed as dependent variables, only the Physical Component Summary (PCS) score (r = .30, p = .02), and not the Mental (r = .06, p = .67), was associated with degree of polypharmacy. This association with PCS score remained significant even after controlling for age, sex, and chronic disease score (adjustedβ= -.91, p = .045). This study is the first to describe the relationship between polypharmacy and HRQoL among a group of American Indians, and the results support the need for larger and more comprehensive studies of medication use in this special population. [ABSTRACT FROM PUBLISHER]