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Cancers
Special Issues
Quality of Life in Underrepresented Cancer Populations
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Quality of Life in Underrepresented Cancer Populations

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (30 July 2021) | Viewed by 20091

Special Issue Editors

Prof. Gwendolyn P. Quinn

E-Mail Website
Guest Editor
Department of Population Health at NYU Grossman School of Medicine, New York University, New York, United States
Interests: quality of life; adolescent and young adult health disparities; reproductive health; sexual health; fertility; sexual and gender minorities
Prof. Matthew B. Schabath

E-Mail Website
Guest Editor
Moffitt Cancer Center, Tampa, United States
Interests: interests cancer epidemiology; lung cancer; sexual and gender minorities; early detection; radiomics; genomics

Special Issue Information

Dear Colleagues,

Underrepresented populations comprise a broad array of communities that include racial and ethnic minorities, adolescents and young adults, patients living in rural areas, and sexual and gender minorities. All people, regardless of their demographics, desire quality of life during cancer treatment and into survivorship. Quality of life in a broad sense encompasses one’s sense of well-being and ability to carry out daily activities. However, discrete aspects of life quality involve a host of constructs: financial, being free from pain, sexual health, fertility, access to care, time spent in seeking care, and supportive and palliative care services. This edition will focus on aspects of quality of life in underrepresented populations and highlight the similarities and differences between these groups and majority populations. The inclusion of these underrepresented groups in clinical trials is a key component of improving future outcomes and quality of life, yet some trials and behavioral interventions may need to be adapted or restructured to meet the needs of underrepresented populations with cancer and into survivorship.

Prof. Gwendolyn P. Quinn
Prof. Matthew B. Schabath
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • several keywords for this special issue: health disparities
  • rurality
  • adolescent and young adult oncology
  • quality of life
  • clinical trials
  • racial and ethnic minorities
  • sexual and gender minorities
  • reproductive health

Published Papers (7 papers)

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Editorial

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3 pages, 173 KiB  
Editorial
Quality of Life in Underrepresented Cancer Populations
by Gwendolyn P. Quinn and Matthew B. Schabath
Cancers 2022, 14(14), 3417; https://doi.org/10.3390/cancers14143417 - 14 Jul 2022
Viewed by 1016
Abstract
This series of six articles (five original articles and one review) is presented by international leaders in health disparities research [...] Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)

Research

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12 pages, 609 KiB  
Article
Cognitive Impairment in Older Cancer Patients Treated with First-Line Chemotherapy
by Mélanie Dos Santos, Idlir Licaj, Carine Bellera, Laurent Cany, Giulia Binarelli, Pierre Soubeyran and Florence Joly
Cancers 2021, 13(24), 6171; https://doi.org/10.3390/cancers13246171 - 7 Dec 2021
Cited by 6 | Viewed by 2716
Abstract
Older cancer patients are vulnerable to chemotherapy-related cognitive impairment. We prospectively evaluated cognitive impairment and its predictive factors during first-line chemotherapy in elderly cancer patients (≥70 years). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) with adjusted scores for age and [...] Read more.
Older cancer patients are vulnerable to chemotherapy-related cognitive impairment. We prospectively evaluated cognitive impairment and its predictive factors during first-line chemotherapy in elderly cancer patients (≥70 years). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) with adjusted scores for age and sociocultural level. Multidimensional geriatric assessment was performed at baseline and during chemotherapy including the MMSE, Instrumental Activities in Daily Living (IADL), Mini-Nutritional Assessment (MNA), and the Geriatric Depression Scale (GDS15). Quality of life (QoL) was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ-C30). Of 364 patients included, 310 had two MMSE evaluations including one at baseline and were assessed. Among these patients, 86 (27.7%) had abnormal MMSE, 195 (62.9%) abnormal MNA, 223 (71.9%) abnormal IADL, and 137 (43.1%) had depressive symptoms at baseline. MMSE impairment during chemotherapy was observed in 58 (18.7%) patients. Abnormal baseline MNA (odds ratio (OR) = 1.87, p = 0.021) and MMSE (OR = 2.58, p = 0.022) were independent predictive factors of MMSE impairment. These results suggest that pre-existing cognitive impairment and malnutrition are predictive factors for cognitive decline during chemotherapy in elderly cancer patients. Detection and management of these risk factors should be systematically considered in this population before starting chemotherapy. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
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11 pages, 533 KiB  
Communication
Characterizing Low-Risk Breast and Gynecological Cancer Patients for Transition into an Oncology/Primary Care Coordinated Care Model: Findings from a Survey of Diverse Survivors in a Rural U.S. State
by Miria Kano, Lu Chen, Tawny Boyce, Ricardo Gomez, Amy C. Gundelach, Shoshana Adler Jaffe, Andrew L. Sussman, Zoneddy R. Dayao, Jolene Lobo, Claire R. Pestak and Teresa L. Rutledge
Cancers 2021, 13(17), 4428; https://doi.org/10.3390/cancers13174428 - 2 Sep 2021
Cited by 2 | Viewed by 2222
Abstract
We conducted a survey to characterize the key attributes of racial/ethnic and geographically diverse low-risk breast and gynecologic cancer patients. We collected data regarding patients’ access to primary care (PC); compliance with screening recommendations; treatment for comorbidities; logistical barriers to clinic visits; and [...] Read more.
We conducted a survey to characterize the key attributes of racial/ethnic and geographically diverse low-risk breast and gynecologic cancer patients. We collected data regarding patients’ access to primary care (PC); compliance with screening recommendations; treatment for comorbidities; logistical barriers to clinic visits; and receipt of survivorship care documentation (SCD). Survey findings informed the development of an oncology/Primary Care Provider (PCP) care coordination intervention to improve care. We distributed a cross-sectional survey among a convenience sample of 150 cancer survivors. Responses were calculated using descriptive statistics and compared based on the distance participants traveled to their appointments at the cancer center (≤30 vs. >30 miles). Of the 150 respondents, 35% traveled >30 miles for follow-up care and 78% reported having one or more comorbid condition(s). PC utilization was high: 88% reported having a PCP, and 91% indicated ≤1 yearly follow-up visit. Participants traveling >30 miles reported higher rates of logistical challenges associated with cancer center visits compared to those traveling ≤30 miles. Nearly half of respondents (46%) had not received SCD. In conclusion, survey studies such as these allow for the systematic assessment of survivor behaviors and care utilization patterns to inform the development of care coordination interventions for diverse, low-risk cancer patients. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
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12 pages, 254 KiB  
Article
Comparing Breast Cancer Experiences and Quality of Life between Lesbian and Heterosexual Women
by Maya Borowczak, Marie C. Lee, Emily Weidenbaum, Anne Mattingly, Anne Kuritzky and Gwendolyn P. Quinn
Cancers 2021, 13(17), 4347; https://doi.org/10.3390/cancers13174347 - 27 Aug 2021
Cited by 4 | Viewed by 2327
Abstract
Background: While breast cancer among women in general has been well studied, little is known about breast cancer in sexual minority women (SMW). Aside from being at an increased risk for development of, and mortality from, breast cancer compared to their heterosexual counterparts, [...] Read more.
Background: While breast cancer among women in general has been well studied, little is known about breast cancer in sexual minority women (SMW). Aside from being at an increased risk for development of, and mortality from, breast cancer compared to their heterosexual counterparts, there is a growing collection of literature that suggests that SMW experience breast cancer differently to heterosexual women. Methods: Qualitative study of both straight and lesbian women with a diagnosis of breast cancer. Focus groups were conducted to assess straight and SMW experiences pertaining to perceived barriers, resources/support from partners as well as attitudes pertaining to breast reconstruction. Results: A sample of 15 participants (10 straight and 5 lesbian women) were included in the present study. Focus group themes focused on support, wishes for support, satisfaction with inclusion of partner, fear, perceived discrimination, quality of life, body image, treatment delay, financial concern, frustration with the system, reconstruction, access to information, and attitudes towards cancer diagnosis. A majority of women in both groups chose to undergo breast reconstruction. Conclusion: In our study, SMW experienced their breast cancer treatment through a uniquely supportive and positive lens, often with higher relationship satisfaction and better self-image when compared to straight women. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
13 pages, 885 KiB  
Article
Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study
by Lena Fauske, Øyvind S. Bruland, Alv A. Dahl, Aase Myklebostad and Silje E. Reme
Cancers 2021, 13(16), 4076; https://doi.org/10.3390/cancers13164076 - 13 Aug 2021
Cited by 6 | Viewed by 6108
Abstract
Background: We report on a pilot intervention study exploring the efficacy of the Lightning Process® training programme for reducing chronic fatigue and improving health-related quality of life in cancer survivors. Methods: 13 adolescent and young adult cancer survivors previously treated for sarcoma [...] Read more.
Background: We report on a pilot intervention study exploring the efficacy of the Lightning Process® training programme for reducing chronic fatigue and improving health-related quality of life in cancer survivors. Methods: 13 adolescent and young adult cancer survivors previously treated for sarcoma or Hodgkin lymphoma were enrolled. A mixed-methods approach was applied. This involved the use of five validated patient-reported outcome measure (PROM) questionnaires at baseline and the three- and six-month follow-up points to obtain quantitative data. Semi-structured interviews were conducted after the intervention with emphasis on the participants’ experiences and outcomes. A reflexive thematic analysis was applied to the transcripts. Results: A significant reduction (p < 0.001) in the total fatigue score from baseline to the three- and six-month follow-up points was documented. The correlation coefficients between the various PROMs at baseline and the six-month follow-up point indicated considerable overlap between the measures. The qualitative findings of the interviews corresponded well with the PROM findings. Most participants experienced both less fatigue and explicit improvement in their energy level. The aspects of the intervention found to be particularly helpful were the theoretical rationale and the coping techniques mediated. Conclusion: These encouraging results here reported should be of interest to the general oncological community, although they require confirmation through a larger and controlled study. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
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14 pages, 633 KiB  
Article
Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study
by Charleen I. Theroux, Kylie N. Hill, Anna L. Olsavsky, James L. Klosky, Nicholas D. Yeager, Anthony Audino, Sarah H. O’Brien, Gwendolyn P. Quinn, Cynthia A. Gerhardt and Leena Nahata
Cancers 2021, 13(14), 3559; https://doi.org/10.3390/cancers13143559 - 16 Jul 2021
Cited by 10 | Viewed by 1979
Abstract
Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among [...] Read more.
Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
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Review

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15 pages, 646 KiB  
Review
Decisional Regret in Female Oncofertility Decision Making—An Integrative Narrative Review
by Vânia Gonçalves
Cancers 2021, 13(19), 4735; https://doi.org/10.3390/cancers13194735 - 22 Sep 2021
Cited by 10 | Viewed by 2554
Abstract
It is well established that fertility is an important issue for young women with cancer at reproductive age, as many have not initiated or completed their parenthood goals when diagnosed. Because cancer treatments may impair fertility, women face fertility decisions that are often [...] Read more.
It is well established that fertility is an important issue for young women with cancer at reproductive age, as many have not initiated or completed their parenthood goals when diagnosed. Because cancer treatments may impair fertility, women face fertility decisions that are often complex and surrounded by uncertainty. This may put patients at risk for psychological distress and the experience of regret regarding decisions made at diagnosis, which may be associated with a negative impact on women’s QoL. This narrative review addresses current knowledge about decisional regret regarding fertility preservation decisions in adult female cancer patients at reproductive age. Electronic searches were conducted on Pubmed database for articles published in English from 1 January 2000 to 1 July 2021 that assessed decisional regret following fertility decisions in young women diagnosed at childbearing age. Of the 96 articles identified, nine provided information on decisional regret regarding fertility decisions. Studies reported that, overall, decisional regret regarding oncofertility decisions was low. Factors associated with the experience of decisional regret were patients’ perceived quality and satisfaction with fertility counseling received, the decision to undergo fertility preservation, desire for children and decisional conflict. Health providers should be aware of the factors that are potentially modifiable and prone to improvement in order to reduce decisional regret. All efforts should be made to improve availability of and access to tailored high quality fertility counseling and fertility preservation. Given the growing evidence that decision aids (DAs) are effective in increasing knowledge and reducing decisional conflict and regret, their use in a routine and timely manner to complement fertility counseling is recommended. Full article
(This article belongs to the Special Issue Quality of Life in Underrepresented Cancer Populations)
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