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Cancers
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Cancer Survivorship
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Cancer Survivorship

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 (15 April 2021) | Viewed by 52746

Special Issue Editors

Dr. Saskia F.A. Duijts

E-Mail Website
Leading Guest Editor
The Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
Interests: psychosocial oncology; cancer survivorship; supportive cancer care; rare cancers; occupational health; epidemiology
Dr. Evelien R. Spelten

E-Mail Website
Co-Guest Editor
Department of Public Health, La Trobe University, Bundoora, VIC 3086, Australia
Interests: psychosocial oncology; supportive cancer care; organization of care; quality of care.

Special Issue Information

Dear Colleagues,

For a long time, cancer survivorship has received little prioritization and attention. Due to developments in cancer screening and treatment, the 10-year survival rate in patients diagnosed in countries with a well‐developed healthcare system is expected to reach 75% in 2030. Since more and more individuals are living with the long-term consequences of a cancer diagnosis and its treatment, it is becoming increasingly important to address cancer survivorship issues.

In 1989, it had already been decided by the National Coalition for Cancer Survivorship that a person should be considered a survivor from the time of diagnosis onward. Up to that time, the term ‘cancer survivor’ was deemed by the medical community to refer to someone who had remained disease-free for a minimum of 5 years. However, coalition members reasoned that cancer patients could not wait five years to make decisions about outcomes that would be affected by specific treatment choices. Relatedly, cancer survivorship research has become more sophisticated over time. While studies in the 2000s mainly focused on the incidence and prevalence of adverse effects, including physical, psychological and social problems, and interventions to treat these, more recent studies examine the risk for poor outcomes and cost-effectiveness of health care provision, with an overall aim to reduce preventable morbidity and mortality among long-term survivors.

Nowadays, numerous topics are part of cancer survivorship research, e.g., rehabilitation, health behavior, e-health, social inequality, return to work, transition of supportive care from secondary to primary care, quality of life, cognitive dysfunction, sexual problems, depression, stigmatization, but also methodological and measurement issues, and many more. This Special Issue encompasses new research articles, timely reviews and experts’ perspectives on a range of topics related to cancer survivorship. Experts in the field are invited to share their recent findings and new ideas.

Dr. Saskia F.A. Duijts
Dr. Evelien R. Spelten
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

  • survivor,
  • physical,
  • psychological,
  • social,
  • behavioral,
  • quality of life,
  • long-term treatment effects,
  • supportive care,
  • cancer continuum

Published Papers (19 papers)

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Editorial

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5 pages, 209 KiB  
Editorial
Cancer Survivorship Issues: Dissemination and Translation of Evidence-Based Knowledge
by Saskia F. A. Duijts and Evelien R. Spelten
Cancers 2021, 13(22), 5794; https://doi.org/10.3390/cancers13225794 - 18 Nov 2021
Cited by 3 | Viewed by 1652
Abstract
This issue of Cancers is a Special Issue focusing on ‘cancer survivorship’ [...] Full article
(This article belongs to the Special Issue Cancer Survivorship)

Research

Jump to: Editorial, Other

16 pages, 791 KiB  
Article
Loss of Paid Employment up to 4 Years after Colorectal Cancer Diagnosis—A Nationwide Register-Based Study with a Population-Based Reference Group
by Astrid de Wind, Sietske J. Tamminga, Claudia A. G. Bony, Maren Diether, Martijn Ludwig, Miranda J. Velthuis, Saskia F. A. Duijts and Angela G. E. M. de Boer
Cancers 2021, 13(12), 2868; https://doi.org/10.3390/cancers13122868 - 8 Jun 2021
Cited by 10 | Viewed by 2281
Abstract
Cancer survivors consider work as a key aspect of cancer survivorship while previous research indicated that cancer survivors have a higher risk of unemployment. The objectives were to assess: (1) whether colorectal cancer survivors less often have paid employment at diagnosis compared to [...] Read more.
Cancer survivors consider work as a key aspect of cancer survivorship while previous research indicated that cancer survivors have a higher risk of unemployment. The objectives were to assess: (1) whether colorectal cancer survivors less often have paid employment at diagnosis compared to a population-based reference group, (2) whether colorectal cancer survivors with paid work have a higher risk of loss of employment up to 4 years after diagnosis compared to a population-based reference group and (3) which colorectal cancer survivors are at highest risk of loss of paid employment. In a nationwide register-based study, persons diagnosed with colorectal cancer (N = 12,007) as registered in the Netherlands Cancer Registry, were compared on loss of paid employment with a sex and age-matched population-based reference group (N = 48,028) from Statistics Netherlands. Cox regression analyses were conducted. Colorectal cancer survivors had a higher risk of loss of paid employment (HR 1.56 [1.42, 1.71]). Within the group of colorectal cancer survivors, risk of loss of paid employment was lower for older survivors (>60 vs. 45–55) (HR 0.64 [0.51, 0.81]) and higher for those with a more advanced cancer stage (IV vs. I) (HR 1.89 [1.33, 2.70]) and those receiving radiotherapy (HR 1.37 [1.15, 1.63]). Colorectal cancer survivors at high risk of loss of paid employment may benefit from work support interventions as part of cancer survivorship. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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15 pages, 2083 KiB  
Article
Health-Related Quality of Life in Very Long-Term Cancer Survivors 14–24 Years Post-Diagnosis Compared to Population Controls: A Population-Based Study
by Daniela Doege, Melissa S. Y. Thong, Linda Weißer, Lena Koch-Gallenkamp, Lina Jansen, Heike Bertram, Andrea Eberle, Bernd Holleczek, Alice Nennecke, Ron Pritzkuleit, Annika Waldmann, Sylke Ruth Zeissig, Hermann Brenner and Volker Arndt
Cancers 2021, 13(11), 2754; https://doi.org/10.3390/cancers13112754 - 1 Jun 2021
Cited by 12 | Viewed by 5165
Abstract
(1) Background: Little is known about the health-related quality of life (HRQoL) in very long-term cancer survivors (VLTCS) 10 and more years post-diagnosis. The objective was to compare cancer survivors’ HRQoL 14–24 years post-diagnosis with that of same-aged non-cancer controls, stratified by age, [...] Read more.
(1) Background: Little is known about the health-related quality of life (HRQoL) in very long-term cancer survivors (VLTCS) 10 and more years post-diagnosis. The objective was to compare cancer survivors’ HRQoL 14–24 years post-diagnosis with that of same-aged non-cancer controls, stratified by age, sex, and disease status (disease-free vs. stage IV, recurrence, metastasis, or second cancer). (2) Methods: We recruited 2704 very long-term survivors of breast, colorectal and prostate cancer, and 1765 controls in German multi-regional population-based studies. The HRQoL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Differences in the HRQoL were estimated with multiple regression, controlling for age, sex (where appropriate), and education. (3) Results: The overall global health status/quality of life of VLTCS more than a decade after diagnosis was slightly higher than that of population controls of the same age, but more symptoms and lower functioning were reported. Differences were small but statistically significant. Results differed by age, sex, and disease status. (4) Conclusions: The findings point out the need for a comprehensive survivorship care program in order to monitor and treat potential late and long-term effects after the diagnosis and treatment of cancer. Survivorship care should be risk-adapted to survivors’ needs according to sociodemographic and clinical factors. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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11 pages, 470 KiB  
Article
Colorectal Cancer Anatomical Site and Sleep Quality
by Mimi Ton, Nathaniel F. Watson, Arthur Sillah, Rachel C. Malen, Julia D. Labadie, Adriana M. Reedy, Stacey A. Cohen, Andrea N. Burnett-Hartman, Polly A. Newcomb and Amanda I. Phipps
Cancers 2021, 13(11), 2578; https://doi.org/10.3390/cancers13112578 - 25 May 2021
Cited by 6 | Viewed by 2646
Abstract
Purpose: Sleep quality in relation to anatomic site among colorectal cancer (CRC) patients is not well understood, though discerning the relationship could contribute to improved survivorship care. Methods: We ascertained sleep quality (Pittsburgh Sleep Quality Index) and other personal characteristics within an ongoing [...] Read more.
Purpose: Sleep quality in relation to anatomic site among colorectal cancer (CRC) patients is not well understood, though discerning the relationship could contribute to improved survivorship care. Methods: We ascertained sleep quality (Pittsburgh Sleep Quality Index) and other personal characteristics within an ongoing population-based study of CRC patients identified through a cancer registry (N = 1453). Differences in sleep quality by CRC site were analyzed using chi-square and ANOVA tests. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of tumor site with sleep quality concerns, adjusting for patient attributes and time since diagnosis. Results: Sleeping problems were reported by 70% of CRC patients. Overall, participants with rectal (vs. colon) cancer were more likely (OR (95% CI)) to report general trouble sleeping (1.58 (1.19, 2.10)). Rectal cancer patients were also more likely than colon cancer patients to report changes in sleep patterns after cancer diagnosis (1.38 (1.05, 1.80)), and trouble sleeping specifically due to getting up to use the bathroom (1.53 (1.20, 1.96)) or pain (1.58 (1.15, 2.17)), but were less likely to report trouble sleeping specifically due to issues with breathing/coughing/snoring (0.51 (0.27, 0.99)). Conclusion: Overall, rectal cancer patients were more likely to have sleep complications compared to colon cancer patients. This suggests sleep-focused survivorship care may be adapted according to CRC site to ensure patients receive appropriate support. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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14 pages, 2235 KiB  
Article
The Impact of Illness Perceptions and Coping Strategies on Use of Supportive Care for Cancer
by Peta Stephenson, Eva Yuen, Gemma Skaczkowski, Evelien R. Spelten, Sheina Orbell and Carlene Wilson
Cancers 2021, 13(10), 2501; https://doi.org/10.3390/cancers13102501 - 20 May 2021
Cited by 6 | Viewed by 3101
Abstract
Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and [...] Read more.
Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and the mediating role of coping strategies. Cancer patients and survivors (n = 336 from Australia, n = 61 from the UK; 191 males, 206 females) aged 20–83 years (Mean (M) = 62.73, Standard Deviation (SD) = 13.28) completed an online questionnaire. Predictor variables were cognitive and emotional representations of cancer, as measured by the Illness Perception Questionnaire—Revised (IPQ-R), and problem- and emotion-focused coping strategies, as measured by the Brief-Coping Orientation to Problems Experienced inventory (Brief-COPE). The outcome variable was survivorship support programme use within the preceding month. Perceived personal control over cancer predicted supportive care use, but cancer-related emotional distress did not. Coping was an inconsistent mediator of the relationships. Problem-focused coping mediated the relationship between personal control and supportive care use; emotion-focused coping did not mediate between emotional responses to cancer and the uptake of survivorship support programmes. The Common Sense Model provides a useful framework for understanding survivorship support programme use. However, more clarity around the relationship between illness beliefs and coping is required. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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31 pages, 4878 KiB  
Article
Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial
by Ursula M. Sansom-Daly, Claire E. Wakefield, Sarah J. Ellis, Brittany C. McGill, Mark W. Donoghoe, Phyllis Butow, Richard A. Bryant, Susan M. Sawyer, Pandora Patterson, Antoinette Anazodo, Megan Plaster, Kate Thompson, Lucy Holland, Michael Osborn, Fiona Maguire, Catherine O’Dwyer, Richard De Abreu Lourenco, Richard J. Cohn and The Recapture Life Working Party
Cancers 2021, 13(10), 2460; https://doi.org/10.3390/cancers13102460 - 18 May 2021
Cited by 23 | Viewed by 5049
Abstract
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors’ mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention (‘Recapture Life’) in a 3-arm randomized-controlled trial comparing [...] Read more.
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors’ mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention (‘Recapture Life’) in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00–15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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13 pages, 704 KiB  
Article
Trajectories of Cognitive Symptoms in Sick-Listed Cancer Survivors
by Kete M. Klaver, Sanne B. Schagen, Jacobien M. Kieffer, Allard J. van der Beek and Saskia F. A. Duijts
Cancers 2021, 13(10), 2444; https://doi.org/10.3390/cancers13102444 - 18 May 2021
Cited by 6 | Viewed by 1413
Abstract
Many non-central nervous system (CNS) cancer survivors experience cognitive symptoms, which may affect their self-perceived work ability. Little is known about trajectories of self-perceived cognitive functioning in cancer survivors in the period after work disability assessment. Therefore, we evaluated: (1) trajectories of self-reported [...] Read more.
Many non-central nervous system (CNS) cancer survivors experience cognitive symptoms, which may affect their self-perceived work ability. Little is known about trajectories of self-perceived cognitive functioning in cancer survivors in the period after work disability assessment. Therefore, we evaluated: (1) trajectories of self-reported cognitive functioning, in cancer survivors with work capacity, (2) differences in trajectories of self-reported cognitive functioning between three work disability groups, and (3) explanatory factors of trajectories of self-reported cognitive functioning. Participants (n = 206) were assessed on self-reported cognitive functioning at three time points between two and four years after first day of sick leave. A statistically significant improvement in cognitive functioning was found in the total group (β = 4.62, SE = 0.91, p < 0.001). When comparing cancer survivors in different work disability groups, similar trajectories of cognitive functioning were observed. Fatigue was the only factor found to be associated with the reported trajectory (β = −0.23, SE = 0.086, p = 0.08). Self-perceived cognitive functioning scores remained considerably lower than the mean score of the general Dutch population, indicating that cognitive symptoms are a persistent problem in sick-listed cancer survivors and that evidence-based treatment options are warranted. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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12 pages, 566 KiB  
Article
A Classification Approach for Cancer Survivors from Those Cancer-Free, Based on Health Behaviors: Analysis of the Lifelines Cohort
by Francisco O. Cortés-Ibañez, Sunil Belur Nagaraj, Ludo Cornelissen, Grigory Sidorenkov and Geertruida H. de Bock
Cancers 2021, 13(10), 2335; https://doi.org/10.3390/cancers13102335 - 12 May 2021
Cited by 1 | Viewed by 1596
Abstract
Health behaviors affect health status in cancer survivors. We hypothesized that nonlinear algorithms would identify distinct key health behaviors compared to a linear algorithm and better classify cancer survivors. We aimed to use three nonlinear algorithms to identify such key health behaviors and [...] Read more.
Health behaviors affect health status in cancer survivors. We hypothesized that nonlinear algorithms would identify distinct key health behaviors compared to a linear algorithm and better classify cancer survivors. We aimed to use three nonlinear algorithms to identify such key health behaviors and compare their performances with that of a logistic regression for distinguishing cancer survivors from those without cancer in a population-based cohort study. We used six health behaviors and three socioeconomic factors for analysis. Participants from the Lifelines population-based cohort were binary classified into a cancer-survivors group and a cancer-free group using either nonlinear algorithms or logistic regression, and their performances were compared by the area under the curve (AUC). In addition, we performed case–control analyses (matched by age, sex, and education level) to evaluate classification performance only by health behaviors. Data were collected for 107,624 cancer free participants and 2760 cancer survivors. Using all variables resulted an AUC of 0.75 ± 0.01, using only six health behaviors, the logistic regression and nonlinear algorithms differentiated cancer survivors from cancer-free participants with AUCs of 0.62 ± 0.01 and 0.60 ± 0.01, respectively. The main distinctive classifier was age. Though not relevant to classification, the main distinctive health behaviors were body mass index and alcohol consumption. In the case–control analyses, algorithms produced AUCs of 0.52 ± 0.01. No key health behaviors were identified by linear and nonlinear algorithms to differentiate cancer survivors from cancer-free participants in this population-based cohort. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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17 pages, 244 KiB  
Article
How Do We Define and Measure Optimal Care for Cancer Survivors? An Online Modified Reactive Delphi Study
by Karolina Lisy, Lena Ly, Helana Kelly, Melanie Clode and Michael Jefford
Cancers 2021, 13(10), 2299; https://doi.org/10.3390/cancers13102299 - 11 May 2021
Cited by 9 | Viewed by 2276
Abstract
This research sought to answer the question ‘what quality criteria do survivorship experts consider to be important in achieving optimal cancer survivorship care?’. An online modified reactive Delphi survey consisting of two rounds was completed with experts including consumers, clinicians, researchers, policymakers and [...] Read more.
This research sought to answer the question ‘what quality criteria do survivorship experts consider to be important in achieving optimal cancer survivorship care?’. An online modified reactive Delphi survey consisting of two rounds was completed with experts including consumers, clinicians, researchers, policymakers and quality and accreditation professionals. Survey items were based on international literature and considered three domains: Policy, process and outcome. In round 1 (R1), experts ranked the importance of 68 criteria on a five-point Likert scale. Criteria were retained if scored 4 (important) or 5 (very important) by >75% participants. In round 2 (R2), experts ranked top 10 criteria per domain. Response rates were 79% (70/89) and 84% (76/91), respectively. After R1, six criteria were removed and six were added. From R2, ten items for each domain were retained. These 30 items formed the Quality Framework. A consensus meeting considered priority items from the Quality Framework and feasibility of data collection. Prioritized items included having a policy on survivorship care; the existence of a multidisciplinary survivorship program (policy); appropriate processes to assess survivors’ emotional, psychological and physical needs following treatment and stratification to appropriate models of care (process); and collecting patient-reported outcomes, quality of life and survival rates (outcome). Full article
(This article belongs to the Special Issue Cancer Survivorship)
14 pages, 792 KiB  
Article
Psychological Resilience and Health-Related Quality of Life in 418 Swedish Women with Primary Breast Cancer: Results from a Prospective Longitudinal Study
by Åsa Mohlin, Pär-Ola Bendahl, Cecilia Hegardt, Corinna Richter, Ingalill Rahm Hallberg and Lisa Rydén
Cancers 2021, 13(9), 2233; https://doi.org/10.3390/cancers13092233 - 6 May 2021
Cited by 13 | Viewed by 2601
Abstract
Psychological resilience is considered a major protective psychological mechanism that enables a person to successfully handle significant adversities, e.g., a cancer diagnosis. Higher levels of resilience have been associated with higher levels of health-related quality of life (HRQoL) in breast cancer (BC) patients, [...] Read more.
Psychological resilience is considered a major protective psychological mechanism that enables a person to successfully handle significant adversities, e.g., a cancer diagnosis. Higher levels of resilience have been associated with higher levels of health-related quality of life (HRQoL) in breast cancer (BC) patients, but research examining the longitudinal process of resilience is limited. The aim of this population-based longitudinal study was to investigate resilience and HRQoL from diagnosis to one year later in 418 Swedish women with primary BC. Resilience was measured with the Connor–Davidson Resilience Scale 25, and HRQoL was measured with the Short Form Health Survey. The participants responded to questions regarding demographic and study-specific variables. Clinicopathological variables were collected from the Swedish National Quality Register for Breast Cancer. The mean score for resilience was 70.6 (standard deviation, SD = 13.0) at diagnosis and 68.9 (SD = 14.0) one year later, p < 0.001. The level of trust in the treatment and financial situation demonstrated the greatest association with the change in resilience levels. No oncological treatment modality was associated with a change in resilience levels. HRQoL decreased over time in the cohort. Resilience was positively associated with HRQoL at one year post diagnosis, which demonstrates that resilience is an important factor in maintaining HRQoL. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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9 pages, 697 KiB  
Article
Cancer Patients Have an Increased Incidence of Dementia: A Retrospective Cohort Study of 185,736 Outpatients in Germany
by Christoph Roderburg, Sven H. Loosen, Anselm Kunstein, Raphael Mohr, Markus S. Jördens, Mark Luedde, Karel Kostev and Tom Luedde
Cancers 2021, 13(9), 2027; https://doi.org/10.3390/cancers13092027 - 22 Apr 2021
Cited by 12 | Viewed by 2123
Abstract
Background: Cancer is the second leading cause of death worldwide and incidence rates for several tumor entities are rising. In addition to a high cancer-specific mortality rate, many cancer patients also suffer from additional comorbidities. Among these, several psychological morbidities have been extensively [...] Read more.
Background: Cancer is the second leading cause of death worldwide and incidence rates for several tumor entities are rising. In addition to a high cancer-specific mortality rate, many cancer patients also suffer from additional comorbidities. Among these, several psychological morbidities have been extensively studied in the past, but findings on the association between cancer and dementia have remained conflicting. In the present study, we evaluated the possibility of an association between cancer and dementia. Methods: Based on data from the IQVIA Disease Analyzer database, a total of 92,868 cancer outpatients initially diagnosed between 2000 and 2018 were matched by age, gender, index year, and yearly consultation frequency to 92,868 individuals without cancer. Ten-year incidence rates of dementia were compared for the two cohorts. Results: The overall cumulative incidence of dementia was significantly higher in cancer patients (19.7%) than in non-cancer patients (16.7%, p < 0.001). Cox regression models confirmed that this association was significant for both male (HR: 1.35 [1.30–1.41], p < 0.001) and female (HR: 1.26 [1.21–1.31], p < 0.001) patients and was consistent among all age groups analyzed (65–70, 71–75, 76–80, 81–85, and >85 years). In addition, the association between cancer and dementia was significant for all cancer entities analyzed (skin, digestive organs, prostate, breast, urinary tract, lymphoid and hematopoietic tissue, and lung cancer) and most pronounced in patients with lung cancer (HR: 1.44 [1.28–1.62], p < 0.001). Conclusions: Our data provide strong evidence for an increased incidence of dementia in a large cohort of patients with different cancer entities, which should raise awareness of this important comorbidity in cancer patients. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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12 pages, 1705 KiB  
Article
Risk of Pharmacological or Hospital Treatment for Depression in Patients with Colorectal Cancer–Associations with Pre-Cancer Lifestyle, Comorbidity and Clinical Factors
by Trille Kristina Kjaer, Ida Rask Moustsen-Helms, Vanna Albieri, Signe Benzon Larsen, Thea Helene Degett, Anne Tjønneland, Christoffer Johansen, Susanne K. Kjaer, Ismail Gogenur and Susanne Oksbjerg Dalton
Cancers 2021, 13(8), 1979; https://doi.org/10.3390/cancers13081979 - 20 Apr 2021
Cited by 3 | Viewed by 2020
Abstract
We investigated the risk of depression in colorectal cancer (CRC) patients and associated risk factors. The 1324 patients with CRC and 6620 matched cancer-free participants from the Diet, Cancer and Health study were followed for up to 16 years for either a first [...] Read more.
We investigated the risk of depression in colorectal cancer (CRC) patients and associated risk factors. The 1324 patients with CRC and 6620 matched cancer-free participants from the Diet, Cancer and Health study were followed for up to 16 years for either a first hospitalization for depression or antidepressant prescription after diagnosis of CRC cancer or study entry date. Information on the outcome and covariates was retrieved from the Danish Colorectal Cancer Group database, the national health registries and questionnaires. Cumulative incidence of depression was estimated, and Cox regression models were used to evaluate the association between risk factors and depression incidence. During follow-up, 191 (14.4%) patients with CRC and 175 (2.6%) cancer-free comparison persons experienced depression. After adjustments, in the first year after cancer diagnosis, patients with CRC had a 12-fold higher hazard compared with the cancer-free population (HR, 12.01; 95% CI, 7.89–18.28). The risk decreased during follow-up but remained significantly elevated with an HR of 2.65 (95% CI, 1.61–4.36) after five years. Identified risk factors were presence of comorbidities, advanced disease stage and use of radiotherapy, while life style factors (pre-cancer or at diagnosis) and chemotherapy did not seem to contribute to the increased risk. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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14 pages, 441 KiB  
Article
Perceptions of Chinese Patients Treated for Gynaecological Cancer about Sexual Health and Sexual Information Provided by Healthcare Professionals: A Qualitative Study
by Ka Ming Chow, Carmen W. H. Chan and Bernard M. H. Law
Cancers 2021, 13(7), 1654; https://doi.org/10.3390/cancers13071654 - 1 Apr 2021
Cited by 7 | Viewed by 2637
Abstract
Patients treated for gynaecological cancer (GC) generally experience impaired sexual function. Research on their sexual life experiences and perceptions on the sexuality care they receive is warranted. This study aimed to examine the perceptions of Chinese patients treated for GC regarding the effects [...] Read more.
Patients treated for gynaecological cancer (GC) generally experience impaired sexual function. Research on their sexual life experiences and perceptions on the sexuality care they receive is warranted. This study aimed to examine the perceptions of Chinese patients treated for GC regarding the effects of cancer treatment on their sexual function and femininity, their relationships with their partners, and the adequacy of the sexual information received from healthcare professionals during treatment. Individual, semi-structured interviews were conducted with 21 Chinese patients treated for GC, collecting data on their perceptions regarding the effects of cancer treatment on their sexual lives, femininity, and relationships with partners; and their views about the quality of sexuality care received. Data were analysed using content analysis. Participants experienced impaired sexual function, reduced sex drive, and expressed dissatisfaction with their sex lives. They perceived a loss of femininity and poor body image. They desired more information about how to address sexual problems and opted to receive this information from female healthcare professionals in individual counselling sessions during which the professionals could initiate such discussions. Overall, Chinese patients treated for GC have concerns about multiple sexual issues and a strong desire for information about strategies to address these issues. Nurse-led interventions should be implemented via a shared care approach to enhance patients’ awareness about managing their sexual and psychological symptoms. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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15 pages, 280 KiB  
Article
Improving Survivors’ Quality of Life Post-Treatment: The Perspectives of Rural Australian Cancer Survivors and Their Carers
by Kate M. Gunn, Ian Olver, Xiomara Skrabal Ross, Nathan Harrison, Patricia M. Livingston and Carlene Wilson
Cancers 2021, 13(7), 1600; https://doi.org/10.3390/cancers13071600 - 30 Mar 2021
Cited by 18 | Viewed by 2847
Abstract
The transition from urban centres back to rural and remote communities can be challenging for rural cancer survivors after treatment. This study aimed to (a) provide deeper understanding of the experiences of rural survivors who have completed active cancer treatment and returned to [...] Read more.
The transition from urban centres back to rural and remote communities can be challenging for rural cancer survivors after treatment. This study aimed to (a) provide deeper understanding of the experiences of rural survivors who have completed active cancer treatment and returned to their rural communities, and (b) determine strategies to re-orient existing services or develop new interventions to more appropriately meet rural survivors’ service preferences and needs. Semi-structured interviews were conducted with 22 adults (64% female) who lived outside of a metropolitan area and had completed active cancer treatment (n = 13), were the carer for a rural/remote cancer survivor (n = 6), or were both a survivor and carer (n = 3). Thematic analysis was conducted to identify dominant themes in the qualitative data. A range of physical, psychological and practical challenges that impact quality of life among rural survivors post-treatment were found. These challenges appeared to be compounded by a lack of trust in local rural healthcare services and a lack of clear post-treatment pathways to quality of life-enhancing support services. Acceptable strategies to overcome barriers included nurse-led, telephone-based, or face-to-face interventions, initiated and continued by the same service provider, and that included support to manage emotional challenges associated with post-treatment survivorship. The findings will inform the design of interventions to better meet rural cancer survivors’ post-treatment support needs. Full article
(This article belongs to the Special Issue Cancer Survivorship)
11 pages, 265 KiB  
Article
Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study
by Saskia W. M. C. Maass, Daan Brandenbarg, Liselotte M. Boerman, Peter F. M. Verhaak, Geertruida H. de Bock and Annette J. Berendsen
Cancers 2021, 13(6), 1301; https://doi.org/10.3390/cancers13061301 - 15 Mar 2021
Cited by 24 | Viewed by 2656
Abstract
Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors [...] Read more.
Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety. Full article
(This article belongs to the Special Issue Cancer Survivorship)
11 pages, 938 KiB  
Article
Exploring Older Women’s Attitudes to and Experience of Treatment for Advanced Ovarian Cancer: A Qualitative Phenomenological Study
by Lucy Dumas, Emma Lidington, Laura Appadu, Philippa Jupp, Olga Husson and Susana Banerjee
Cancers 2021, 13(6), 1207; https://doi.org/10.3390/cancers13061207 - 10 Mar 2021
Cited by 9 | Viewed by 2574
Abstract
Older women with ovarian cancer more often receive less intensive treatment and early discontinuation compared to younger women. There is little understanding of older women’s treatment experience and whether this contributes to declining intensive treatment. We aimed to explore the lived experience of [...] Read more.
Older women with ovarian cancer more often receive less intensive treatment and early discontinuation compared to younger women. There is little understanding of older women’s treatment experience and whether this contributes to declining intensive treatment. We aimed to explore the lived experience of older patients with advanced ovarian cancer undergoing chemotherapy, their treatment preferences and treatment burden. We conducted a phenomenological qualitative study with 15 women who had completed at least three cycles of first-line chemotherapy for advanced epithelial ovarian cancer, aged 65 years or older at the first cycle, at one tertiary cancer centre. We conducted interviews and focus groups and analysed the transcripts using inductive thematic analysis. Women reported a strong preference for active treatment despite treatment burden and toxicities. Participants undertook treatment to lengthen their lives for themselves and their families. Participants did not see age as a barrier to treatment. Patients expressed determination not to let cancer interfere with daily life. Women felt overwhelmed with information and struggled with daily tasks due to fatigue. Logistical issues, such as transportation and ineffective communication between healthcare providers, caused substantial distress. Despite these logistical burdens and toxicities, participants were positive about their care experience and desire for anticancer treatment. Older women may benefit from additional support to facilitate effective communication during the early stages of treatment. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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12 pages, 224 KiB  
Article
Perspectives of Esophageal Cancer Survivors on Diagnosis, Treatment, and Recovery
by Annemarie E. Bennett, Linda O’Neill, Deirdre Connolly, Emer Guinan, Lauren Boland, Suzanne Doyle, Jacintha O’Sullivan, John V. Reynolds and Juliette Hussey
Cancers 2021, 13(1), 100; https://doi.org/10.3390/cancers13010100 - 31 Dec 2020
Cited by 17 | Viewed by 3139
Abstract
Esophageal cancer poses challenges to all domains of wellbeing. This qualitative study aimed to explore the experiences of esophageal cancer diagnosis, treatment, and recovery, with a view to informing the health education needs of this group. Eighteen persons who had undergone an esophagectomy [...] Read more.
Esophageal cancer poses challenges to all domains of wellbeing. This qualitative study aimed to explore the experiences of esophageal cancer diagnosis, treatment, and recovery, with a view to informing the health education needs of this group. Eighteen persons who had undergone an esophagectomy participated in one of four audio-taped focus groups in a specialist hospital for cancer care. Transcriptions were analyzed thematically. Fear and uncertainty underpinned all stages of diagnosis, treatment, and recovery. Participants emphasized: (a) a lack of understanding over what to expect throughout treatment and recovery; (b) the demanding and traumatic period of adjustment required as a result of changes to their physical, psychological, and social functioning; and, (c) that support provided by family, friends, and acquaintances was variable and uninformed, often to the point of being counterproductive to physical and psychosocial recovery. Tailored education is needed to enable patients to prepare for each stage of their cancer journey. Equally, families and wider social networks should receive education that enables them to provide esophageal cancer survivors with appropriate support. Education should be provided at intervals that enable patients, survivors, and support networks to prepare for the physical, emotional, and social challenges experienced during diagnosis, treatment, and recovery. Full article
(This article belongs to the Special Issue Cancer Survivorship)

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Jump to: Editorial, Research

7 pages, 477 KiB  
Perspective
Improving Care for Patients Living with Prolonged Incurable Cancer
by Mariken E. Stegmann, Olaf P. Geerse, Lia van Zuylen, Larissa Nekhlyudov and Daan Brandenbarg
Cancers 2021, 13(11), 2555; https://doi.org/10.3390/cancers13112555 - 23 May 2021
Cited by 9 | Viewed by 2301
Abstract
The number of patients that can no longer be cured but may expect to live with their cancer diagnosis for a substantial period is increasing. These patients with ‘prolonged incurable cancer’ are often overlooked in research and clinical practice. Patients encounter problems that [...] Read more.
The number of patients that can no longer be cured but may expect to live with their cancer diagnosis for a substantial period is increasing. These patients with ‘prolonged incurable cancer’ are often overlooked in research and clinical practice. Patients encounter problems that are traditionally seen from a palliative or survivorship perspective but this may be insufficient to cover the wide range of physical and psychosocial problems that patients with prolonged incurable cancer may encounter. Elements from both fields should, therefore, be delivered concordantly to further optimize care pathways for these patients. Furthermore, to ensure future high-quality care for this important patient population, enhanced clinical awareness, as well as further research, are urgently needed. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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8 pages, 480 KiB  
Perspective
Cancer: New Needs, New Models. Is It Time for a Community Oncologist? Another Brick in the Wall
by Paolo Tralongo, Vittorio Gebbia, Sebastiano Mercadante, Roberto Bordonaro, Francesco Ferraù, Sandro Barni and Alberto Firenze
Cancers 2021, 13(8), 1919; https://doi.org/10.3390/cancers13081919 - 16 Apr 2021
Cited by 8 | Viewed by 1743
Abstract
Over the last few decades, thanks to early detection, effective drugs, and personalized treatments, the natural history of cancer has radically changed. Thanks to these advances, we have observed how survival of cancer patients has increased, becoming an ever more important goal in [...] Read more.
Over the last few decades, thanks to early detection, effective drugs, and personalized treatments, the natural history of cancer has radically changed. Thanks to these advances, we have observed how survival of cancer patients has increased, becoming an ever more important goal in cancer care. Effective clinical governance of survivorship care is essential to ensure a successful transition between active and post-treatment life, identifying optimization of healthcare outcomes and quality of life for patients as the primary objectives. For these reasons, potential intervention models must consider these differences to rationalize the available resources, including economic aspects. In this perspective, analyzing the different models proposed in the literature to manage this type of patients, we focus on the possible role of the so-called “community oncologist”. As a trained health professional, also focused on longevity, he could represent the right management solution in all those “intermediate” clinical conditions that arise between the hospital specialist, frequently overworked, and the general practitioner, often biased by the lack of specific expertise. Full article
(This article belongs to the Special Issue Cancer Survivorship)
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