Background: Triple-negative breast cancer (TNBC) has fewer treatment options and is associated with a poor prognosis in the metastatic and adjuvant setting.
Objective: To evaluate the impact of triple-negative (TN) status on disease recurrence and survival among stage I-III patients who were treated with adjuvant chemotherapy in a community-based clinical practice setting.
Methods: Data were extracted from the 2003-2008 Georgia Cancer Specialist Database. Stage I-III breast cancer patients who received adjuvant chemotherapy were followed from initial diagnosis until death, recurrence, or loss to follow-up. The influence of TN status on disease-free survival (DFS) and recurrence was assessed.
Results: The study included 1,572 patients, of whom 26.3% had TNBC. The 5-year DFS was 76.8% for TNBC patients and 89.0% for non-TNBC patients (P less than .001); 5-year recurrence rates were 18.8% for TNBC and 11.2% for non-TNBC (P less than .001). The adjusted likelihood for DFS was lower for TNBC patients (hazard ratio [HR], 0.37; P less than .001), and risk for recurrence was higher (HR, 2.85; P less than .001) compared with non-TNBC patients. In the subpopulation with confirmed race, the comparable adjusted HRs were 0.27 and 4.70 (P less than .001, for both), respectively. African American race was an independent risk factor for worse outcome.
Limitations: Some potential confounding factors are not accounted for in this study, including accessibility to health care, differences in chemotherapy type, dose intensity, and socioeconomic status.
Conclusions: Patients with stage I-III TNBC had shorter DFS and higher recurrence risk, despite having received chemotherapy. The results emphasize the need for more effective treatments.
*To read the full article, click on the PDF icon at the top of this introduction.
Background: Triple-negative breast cancer (TNBC) has fewer treatment options and is associated with a poor prognosis in the metastatic and adjuvant setting.
Objective: To evaluate the impact of triple-negative (TN) status on disease recurrence and survival among stage I-III patients who were treated with adjuvant chemotherapy in a community-based clinical practice setting.
Methods: Data were extracted from the 2003-2008 Georgia Cancer Specialist Database. Stage I-III breast cancer patients who received adjuvant chemotherapy were followed from initial diagnosis until death, recurrence, or loss to follow-up. The influence of TN status on disease-free survival (DFS) and recurrence was assessed.
Results: The study included 1,572 patients, of whom 26.3% had TNBC. The 5-year DFS was 76.8% for TNBC patients and 89.0% for non-TNBC patients (P less than .001); 5-year recurrence rates were 18.8% for TNBC and 11.2% for non-TNBC (P less than .001). The adjusted likelihood for DFS was lower for TNBC patients (hazard ratio [HR], 0.37; P less than .001), and risk for recurrence was higher (HR, 2.85; P less than .001) compared with non-TNBC patients. In the subpopulation with confirmed race, the comparable adjusted HRs were 0.27 and 4.70 (P less than .001, for both), respectively. African American race was an independent risk factor for worse outcome.
Limitations: Some potential confounding factors are not accounted for in this study, including accessibility to health care, differences in chemotherapy type, dose intensity, and socioeconomic status.
Conclusions: Patients with stage I-III TNBC had shorter DFS and higher recurrence risk, despite having received chemotherapy. The results emphasize the need for more effective treatments.
*To read the full article, click on the PDF icon at the top of this introduction.
Background: Triple-negative breast cancer (TNBC) has fewer treatment options and is associated with a poor prognosis in the metastatic and adjuvant setting.
Objective: To evaluate the impact of triple-negative (TN) status on disease recurrence and survival among stage I-III patients who were treated with adjuvant chemotherapy in a community-based clinical practice setting.
Methods: Data were extracted from the 2003-2008 Georgia Cancer Specialist Database. Stage I-III breast cancer patients who received adjuvant chemotherapy were followed from initial diagnosis until death, recurrence, or loss to follow-up. The influence of TN status on disease-free survival (DFS) and recurrence was assessed.
Results: The study included 1,572 patients, of whom 26.3% had TNBC. The 5-year DFS was 76.8% for TNBC patients and 89.0% for non-TNBC patients (P less than .001); 5-year recurrence rates were 18.8% for TNBC and 11.2% for non-TNBC (P less than .001). The adjusted likelihood for DFS was lower for TNBC patients (hazard ratio [HR], 0.37; P less than .001), and risk for recurrence was higher (HR, 2.85; P less than .001) compared with non-TNBC patients. In the subpopulation with confirmed race, the comparable adjusted HRs were 0.27 and 4.70 (P less than .001, for both), respectively. African American race was an independent risk factor for worse outcome.
Limitations: Some potential confounding factors are not accounted for in this study, including accessibility to health care, differences in chemotherapy type, dose intensity, and socioeconomic status.
Conclusions: Patients with stage I-III TNBC had shorter DFS and higher recurrence risk, despite having received chemotherapy. The results emphasize the need for more effective treatments.
*To read the full article, click on the PDF icon at the top of this introduction.
Coping and Psychological Distress in Young Adults With Advanced Cancer
This study identifies coping strategies utilized by young adults with advanced cancer and examines the relationship between these coping strategies and psychological distress.
Background: Little is known about how young adults (YAs) cope with cancer or about the relationship between coping and psychological distress in YAs with advanced cancer.
Objectives: The goals of this study were to identify coping strategies used by YAs with advanced cancer and examine the relationship between these coping strategies and psychological distress.
Methods: Using structured clinical interviews with 53 YAs (aged 20–40 years) with advanced cancer, researchers assessed coping methods, depression, anxiety, and grief. A principal components factor analysis identified underlying coping factors. Regression analyses examined the relationship between these coping factors and depression, anxiety, and grief.
Results: Six coping factors emerged and were labeled as proactive, distancing, negative expression, support-seeking, respite-seeking, and acceptance coping. Acceptance and support-seeking coping styles were used most frequently. Coping by negative expression was positively associated with severity of grief after researchers controlled for depression, anxiety, and confounding variables. Support-seeking coping was positively associated with anxiety after researchers controlled for depression and grief.
Limitations: This study was limited by a cross-sectional design, small sample size, and focus on YAs with advanced cancer.
Conclusions: YAs with advanced cancer utilize a range of coping responses that are uniquely related to psychological distress.
To read this article, click on the FILES link at left.
This study identifies coping strategies utilized by young adults with advanced cancer and examines the relationship between these coping strategies and psychological distress.
This study identifies coping strategies utilized by young adults with advanced cancer and examines the relationship between these coping strategies and psychological distress.
ABSTRACT
Background: Little is known about how young adults (YAs) cope with cancer or about the relationship between coping and psychological distress in YAs with advanced cancer.
Objectives: The goals of this study were to identify coping strategies used by YAs with advanced cancer and examine the relationship between these coping strategies and psychological distress.
Methods: Using structured clinical interviews with 53 YAs (aged 20–40 years) with advanced cancer, researchers assessed coping methods, depression, anxiety, and grief. A principal components factor analysis identified underlying coping factors. Regression analyses examined the relationship between these coping factors and depression, anxiety, and grief.
Results: Six coping factors emerged and were labeled as proactive, distancing, negative expression, support-seeking, respite-seeking, and acceptance coping. Acceptance and support-seeking coping styles were used most frequently. Coping by negative expression was positively associated with severity of grief after researchers controlled for depression, anxiety, and confounding variables. Support-seeking coping was positively associated with anxiety after researchers controlled for depression and grief.
Limitations: This study was limited by a cross-sectional design, small sample size, and focus on YAs with advanced cancer.
Conclusions: YAs with advanced cancer utilize a range of coping responses that are uniquely related to psychological distress.
To read this article, click on the FILES link at left.
ABSTRACT
Background: Little is known about how young adults (YAs) cope with cancer or about the relationship between coping and psychological distress in YAs with advanced cancer.
Objectives: The goals of this study were to identify coping strategies used by YAs with advanced cancer and examine the relationship between these coping strategies and psychological distress.
Methods: Using structured clinical interviews with 53 YAs (aged 20–40 years) with advanced cancer, researchers assessed coping methods, depression, anxiety, and grief. A principal components factor analysis identified underlying coping factors. Regression analyses examined the relationship between these coping factors and depression, anxiety, and grief.
Results: Six coping factors emerged and were labeled as proactive, distancing, negative expression, support-seeking, respite-seeking, and acceptance coping. Acceptance and support-seeking coping styles were used most frequently. Coping by negative expression was positively associated with severity of grief after researchers controlled for depression, anxiety, and confounding variables. Support-seeking coping was positively associated with anxiety after researchers controlled for depression and grief.
Limitations: This study was limited by a cross-sectional design, small sample size, and focus on YAs with advanced cancer.
Conclusions: YAs with advanced cancer utilize a range of coping responses that are uniquely related to psychological distress.
To read this article, click on the FILES link at left.
Background: Breast cancer survivors receive routine medical follow-up but are screened less frequently to detect symptom severity and interference with function in daily life.
Objectives: Among breast cancer survivors, we describe the usual and worst severity of 5 common symptoms and the extent to which these symptoms interfere with general activity and enjoyment of life, we determine the associations among symptoms and the interference items, and we explore associations of interference with function and the most prevalent symptoms.
Methods: The cross-sectional, descriptive 1-page Breast Cancer Survivor Symptom Survey was mailed to breast cancer survivors identified in a clinical database (ONCOBASE). In total, 184/457 (40.3%) surveys were returned and 162 (35.4%) were used. Participants recorded usual and worst severity of 5 symptoms (fatigue, disturbed sleep, pain, distress, and numbness/tingling) and symptom interference with general activity and enjoyment of life during the past 7 days.
Results: Participants reported usual symptom severity as mild and highest for sleep disturbance, followed by fatigue, distress, numbness/tingling, and pain. Participants recorded worst sleep disturbance and fatigue as moderately severe. Higher pain and fatigue were associated with all other symptoms, whereas disturbed sleep and distress were related to all except numbness/tingling. All symptoms interfered with general activity and enjoyment of life. Pain and numbness/tingling were associated with lower function and disturbed sleep, and made a unique contribution to fatigue.
Limitations: Limitations of the study include relatively low response and use of a modification of an established scale.
Conclusion: Symptoms often coexisted and contributed to interference with daily function. Pain was most consistently associated with interference with function and severity of other symptoms.
To read this study, please click on the Link to the left of this abstract.
Background: Breast cancer survivors receive routine medical follow-up but are screened less frequently to detect symptom severity and interference with function in daily life.
Objectives: Among breast cancer survivors, we describe the usual and worst severity of 5 common symptoms and the extent to which these symptoms interfere with general activity and enjoyment of life, we determine the associations among symptoms and the interference items, and we explore associations of interference with function and the most prevalent symptoms.
Methods: The cross-sectional, descriptive 1-page Breast Cancer Survivor Symptom Survey was mailed to breast cancer survivors identified in a clinical database (ONCOBASE). In total, 184/457 (40.3%) surveys were returned and 162 (35.4%) were used. Participants recorded usual and worst severity of 5 symptoms (fatigue, disturbed sleep, pain, distress, and numbness/tingling) and symptom interference with general activity and enjoyment of life during the past 7 days.
Results: Participants reported usual symptom severity as mild and highest for sleep disturbance, followed by fatigue, distress, numbness/tingling, and pain. Participants recorded worst sleep disturbance and fatigue as moderately severe. Higher pain and fatigue were associated with all other symptoms, whereas disturbed sleep and distress were related to all except numbness/tingling. All symptoms interfered with general activity and enjoyment of life. Pain and numbness/tingling were associated with lower function and disturbed sleep, and made a unique contribution to fatigue.
Limitations: Limitations of the study include relatively low response and use of a modification of an established scale.
Conclusion: Symptoms often coexisted and contributed to interference with daily function. Pain was most consistently associated with interference with function and severity of other symptoms.
To read this study, please click on the Link to the left of this abstract.
ABSTRACT
Background: Breast cancer survivors receive routine medical follow-up but are screened less frequently to detect symptom severity and interference with function in daily life.
Objectives: Among breast cancer survivors, we describe the usual and worst severity of 5 common symptoms and the extent to which these symptoms interfere with general activity and enjoyment of life, we determine the associations among symptoms and the interference items, and we explore associations of interference with function and the most prevalent symptoms.
Methods: The cross-sectional, descriptive 1-page Breast Cancer Survivor Symptom Survey was mailed to breast cancer survivors identified in a clinical database (ONCOBASE). In total, 184/457 (40.3%) surveys were returned and 162 (35.4%) were used. Participants recorded usual and worst severity of 5 symptoms (fatigue, disturbed sleep, pain, distress, and numbness/tingling) and symptom interference with general activity and enjoyment of life during the past 7 days.
Results: Participants reported usual symptom severity as mild and highest for sleep disturbance, followed by fatigue, distress, numbness/tingling, and pain. Participants recorded worst sleep disturbance and fatigue as moderately severe. Higher pain and fatigue were associated with all other symptoms, whereas disturbed sleep and distress were related to all except numbness/tingling. All symptoms interfered with general activity and enjoyment of life. Pain and numbness/tingling were associated with lower function and disturbed sleep, and made a unique contribution to fatigue.
Limitations: Limitations of the study include relatively low response and use of a modification of an established scale.
Conclusion: Symptoms often coexisted and contributed to interference with daily function. Pain was most consistently associated with interference with function and severity of other symptoms.
To read this study, please click on the Link to the left of this abstract.
Perceived Social Support as a Predictor of Disease-Specific Quality of Life in Head-and-Neck Cancer Patients
Frank J. Penedo, PhD; Lara Traeger, PhD; Catherine Benedict, MS; Giovana Thomas, MD; Jason R. Dahn, PhD; Madeline Hernandez Krause, MS; and W. Jarrard Goodwin, MD
ABSTRACT
Background: Treatment for head-and-neck cancer (HNC) can lead to severe decrements in disease-specific quality of life (DSQOL) due to disfigurement and disability in speech, eating, and/or breathing. Psychosocial factors such as social support may explain individual variance in DSQOL outcomes.
Objective: The researchers sought to evaluate changes in perceived availability of social support from pretreatment to posttreatment and to determine whether decreases in perceived social support predicted poorer posttreatment DSQOL among HNC patients, controlling for disease-and treatment-related factors.
Methods: Participants (n equals 32) were newly diagnosed with HNC and were awaiting surgery and/or radiation treatment. Measures included the ENRICHD Social Support instrument (ESSI) to assess perceived social support and the Functional Assessment of Cancer Therapy–Head & Neck (FACT-H&N) to assess DSQOL. Paired-samples t-tests and hierarchical regression analyses were conducted to determine relationships between pretreatment and posttreatment perceived social support and DSQOL.
Results: Perceived social support decreased significantly from pre-to posttreatment (F[31] equals –2.71, P less than .01). After adjusting for relevant covariates and pretreatment DSQOL, change in perceived social support remained a significant predictor of posttreatment DSQOL (Beta equals 0.47, P less than .01).
Limitations: This study included a relatively small sample of HNC patients, which limited power to evaluate mechanisms of observed relationships.
Conclusions: Increased social isolation may be a risk factor for poorer physical recovery from, or adjustment to, treatment-related side effects. Social support may be an important target for psychosocial interventions for patients who face challenging treatment side effects.
To read the article, please see the attached pdf file.
Perceived Social Support as a Predictor of Disease-Specific Quality of Life in Head-and-Neck Cancer Patients
Frank J. Penedo, PhD; Lara Traeger, PhD; Catherine Benedict, MS; Giovana Thomas, MD; Jason R. Dahn, PhD; Madeline Hernandez Krause, MS; and W. Jarrard Goodwin, MD
ABSTRACT
Background: Treatment for head-and-neck cancer (HNC) can lead to severe decrements in disease-specific quality of life (DSQOL) due to disfigurement and disability in speech, eating, and/or breathing. Psychosocial factors such as social support may explain individual variance in DSQOL outcomes.
Objective: The researchers sought to evaluate changes in perceived availability of social support from pretreatment to posttreatment and to determine whether decreases in perceived social support predicted poorer posttreatment DSQOL among HNC patients, controlling for disease-and treatment-related factors.
Methods: Participants (n equals 32) were newly diagnosed with HNC and were awaiting surgery and/or radiation treatment. Measures included the ENRICHD Social Support instrument (ESSI) to assess perceived social support and the Functional Assessment of Cancer Therapy–Head & Neck (FACT-H&N) to assess DSQOL. Paired-samples t-tests and hierarchical regression analyses were conducted to determine relationships between pretreatment and posttreatment perceived social support and DSQOL.
Results: Perceived social support decreased significantly from pre-to posttreatment (F[31] equals –2.71, P less than .01). After adjusting for relevant covariates and pretreatment DSQOL, change in perceived social support remained a significant predictor of posttreatment DSQOL (Beta equals 0.47, P less than .01).
Limitations: This study included a relatively small sample of HNC patients, which limited power to evaluate mechanisms of observed relationships.
Conclusions: Increased social isolation may be a risk factor for poorer physical recovery from, or adjustment to, treatment-related side effects. Social support may be an important target for psychosocial interventions for patients who face challenging treatment side effects.
To read the article, please see the attached pdf file.
Perceived Social Support as a Predictor of Disease-Specific Quality of Life in Head-and-Neck Cancer Patients
Frank J. Penedo, PhD; Lara Traeger, PhD; Catherine Benedict, MS; Giovana Thomas, MD; Jason R. Dahn, PhD; Madeline Hernandez Krause, MS; and W. Jarrard Goodwin, MD
ABSTRACT
Background: Treatment for head-and-neck cancer (HNC) can lead to severe decrements in disease-specific quality of life (DSQOL) due to disfigurement and disability in speech, eating, and/or breathing. Psychosocial factors such as social support may explain individual variance in DSQOL outcomes.
Objective: The researchers sought to evaluate changes in perceived availability of social support from pretreatment to posttreatment and to determine whether decreases in perceived social support predicted poorer posttreatment DSQOL among HNC patients, controlling for disease-and treatment-related factors.
Methods: Participants (n equals 32) were newly diagnosed with HNC and were awaiting surgery and/or radiation treatment. Measures included the ENRICHD Social Support instrument (ESSI) to assess perceived social support and the Functional Assessment of Cancer Therapy–Head & Neck (FACT-H&N) to assess DSQOL. Paired-samples t-tests and hierarchical regression analyses were conducted to determine relationships between pretreatment and posttreatment perceived social support and DSQOL.
Results: Perceived social support decreased significantly from pre-to posttreatment (F[31] equals –2.71, P less than .01). After adjusting for relevant covariates and pretreatment DSQOL, change in perceived social support remained a significant predictor of posttreatment DSQOL (Beta equals 0.47, P less than .01).
Limitations: This study included a relatively small sample of HNC patients, which limited power to evaluate mechanisms of observed relationships.
Conclusions: Increased social isolation may be a risk factor for poorer physical recovery from, or adjustment to, treatment-related side effects. Social support may be an important target for psychosocial interventions for patients who face challenging treatment side effects.
To read the article, please see the attached pdf file.
Health-resource utilization attributable to skeletal-related events in patients with advanced cancers associated with bone metastases: results of the US cohort from a multicenter observational study
Background: Patients with advanced cancer and bone metastases frequently experience skeletal-related events (SREs) including pathologic fracture, spinal cord compression, and radiation or surgery to bone. This prospective, observational study characterized health-resource utilization (HRU) associated with each SRE type across tumor types. Methods: Patients with bone metastases secondary to breast, prostate, or lung cancer as well as patients with multiple myeloma were enrolled within 97 days of experiencing an SRE and were followed prospectively for up to 18 months. Data on hospitalization, length of hospital stay, outpatient visits, emergency department visits, nursing home or long-term care facility stays, home health visits, procedures, and medication usage were collected and attributed to SREs by investigators. Results: In all, 238 patients were prospectively followed for a median of 9.5 months after enrollment. Bisphosphonates were prescribed in 77% of patients. Of 510 SREs recorded, 442 were included in the HRU analyses. Spinal cord compression and surgery to bone were associated with the highest rates of inpatient stays (mean, 0.6 hospitalizations per SRE), and length of stay was longest for pathologic fracture (mean, 16 days per SRE). Radiation to bone had the most outpatient visits (mean, 10 visits per SRE) and procedures (mean, 12 per SRE). Limitations: HRU was likely underestimated because patient charts may not have been comprehensive, and the study design did not capture all potential HRU sources. Sample sizes were small for some SRE types. Conclusions: Each SRE type was associated with substantial HRU, and patterns of HRU were unique across SRE type. The HRU burden of SREs in patients with bone metastases is considerable, even with bisphosphonate treatment.
*For a PDF of the full article, click in the link to the left of this introduction.
Background: Patients with advanced cancer and bone metastases frequently experience skeletal-related events (SREs) including pathologic fracture, spinal cord compression, and radiation or surgery to bone. This prospective, observational study characterized health-resource utilization (HRU) associated with each SRE type across tumor types. Methods: Patients with bone metastases secondary to breast, prostate, or lung cancer as well as patients with multiple myeloma were enrolled within 97 days of experiencing an SRE and were followed prospectively for up to 18 months. Data on hospitalization, length of hospital stay, outpatient visits, emergency department visits, nursing home or long-term care facility stays, home health visits, procedures, and medication usage were collected and attributed to SREs by investigators. Results: In all, 238 patients were prospectively followed for a median of 9.5 months after enrollment. Bisphosphonates were prescribed in 77% of patients. Of 510 SREs recorded, 442 were included in the HRU analyses. Spinal cord compression and surgery to bone were associated with the highest rates of inpatient stays (mean, 0.6 hospitalizations per SRE), and length of stay was longest for pathologic fracture (mean, 16 days per SRE). Radiation to bone had the most outpatient visits (mean, 10 visits per SRE) and procedures (mean, 12 per SRE). Limitations: HRU was likely underestimated because patient charts may not have been comprehensive, and the study design did not capture all potential HRU sources. Sample sizes were small for some SRE types. Conclusions: Each SRE type was associated with substantial HRU, and patterns of HRU were unique across SRE type. The HRU burden of SREs in patients with bone metastases is considerable, even with bisphosphonate treatment.
*For a PDF of the full article, click in the link to the left of this introduction.
Background: Patients with advanced cancer and bone metastases frequently experience skeletal-related events (SREs) including pathologic fracture, spinal cord compression, and radiation or surgery to bone. This prospective, observational study characterized health-resource utilization (HRU) associated with each SRE type across tumor types. Methods: Patients with bone metastases secondary to breast, prostate, or lung cancer as well as patients with multiple myeloma were enrolled within 97 days of experiencing an SRE and were followed prospectively for up to 18 months. Data on hospitalization, length of hospital stay, outpatient visits, emergency department visits, nursing home or long-term care facility stays, home health visits, procedures, and medication usage were collected and attributed to SREs by investigators. Results: In all, 238 patients were prospectively followed for a median of 9.5 months after enrollment. Bisphosphonates were prescribed in 77% of patients. Of 510 SREs recorded, 442 were included in the HRU analyses. Spinal cord compression and surgery to bone were associated with the highest rates of inpatient stays (mean, 0.6 hospitalizations per SRE), and length of stay was longest for pathologic fracture (mean, 16 days per SRE). Radiation to bone had the most outpatient visits (mean, 10 visits per SRE) and procedures (mean, 12 per SRE). Limitations: HRU was likely underestimated because patient charts may not have been comprehensive, and the study design did not capture all potential HRU sources. Sample sizes were small for some SRE types. Conclusions: Each SRE type was associated with substantial HRU, and patterns of HRU were unique across SRE type. The HRU burden of SREs in patients with bone metastases is considerable, even with bisphosphonate treatment.
*For a PDF of the full article, click in the link to the left of this introduction.
Health-resource utilization attributable to skeletal-related events in patients with advanced cancers associated with bone metastases: results of the US cohort from a multicenter observational study
Display Headline
Health-resource utilization attributable to skeletal-related events in patients with advanced cancers associated with bone metastases: results of the US cohort from a multicenter observational study
Legacy Keywords
skeletal-related events, SREs, bone metastases, health-resource utilization
Legacy Keywords
skeletal-related events, SREs, bone metastases, health-resource utilization
Depression and Quality of Life in Cancer Patients Undergoing Chemotherapy: Relation between the Zung Self-Rating Depression Scale and Functional Assessment of Cancer Therapy-General
Objective: Although depression is prevalent among cancer patients, it remains underdiagnosed and undertreated. Quality of life is an important outcome in cancer patients and can be measured by questionnaires such as the Functional Assessment of Cancer Therapy-General version (FACT-G). The purpose of our study was to establish whether or not a group of items in FACT-G could be used as a screening tool for depression as well as for assessing quality of life.
Methods: A total of 62 chemotherapy patients (median age, 62 years [range, 22-81 years]; 55% women) completed Zung Self-Rating Depression Scale (ZSDS) and FACT-G questionnaires. Patients with ZSDS scores of 40 or more underwent clinical interviews for major depression. Pearson’s correlation was used to examine the relationship between the ZSDS and FACT-G scores. FACT-G score results were then analyzed to evaluate if subsets of the FACT-G can be used as a screening tool for major depression.
Results: In all, 30 of 62 patients (48%) had ZSDS scores less than 40 and were ruled out for major depression, and 30 of the 32 patients with ZSDS scores greater or equal to 40 participated in clinical interviews. Of those who were interviewed, 7 patients (23%) were confirmed to have major depression. Overall, the prevalence of major depression was 7 of 60 patients (12%; 95% CI: 5%-23%). The ZSDS and FACT-G scores had strong correlation (r -0.75). The composite score of six statements in FACT-G were found to have sensitivity of 100% and specificity of 81% in predicting major depression, using a cut-off value of 12 (range, 0-24). The six statements were, I have a lack of energy; I feel sad; I feel nervous; I am able to enjoy life; I am sleeping well; and I am enjoying the things I usually do for fun.
Conclusions: The prevalence of major depression among all participants was 12%. The ZSDS score and FACT-G score had strong correlation; the subsets of FACT-G may be useful as a screening tool for depression.
*For a PDF of the full article, click on the link to the left of this introduction.
Objective: Although depression is prevalent among cancer patients, it remains underdiagnosed and undertreated. Quality of life is an important outcome in cancer patients and can be measured by questionnaires such as the Functional Assessment of Cancer Therapy-General version (FACT-G). The purpose of our study was to establish whether or not a group of items in FACT-G could be used as a screening tool for depression as well as for assessing quality of life.
Methods: A total of 62 chemotherapy patients (median age, 62 years [range, 22-81 years]; 55% women) completed Zung Self-Rating Depression Scale (ZSDS) and FACT-G questionnaires. Patients with ZSDS scores of 40 or more underwent clinical interviews for major depression. Pearson’s correlation was used to examine the relationship between the ZSDS and FACT-G scores. FACT-G score results were then analyzed to evaluate if subsets of the FACT-G can be used as a screening tool for major depression.
Results: In all, 30 of 62 patients (48%) had ZSDS scores less than 40 and were ruled out for major depression, and 30 of the 32 patients with ZSDS scores greater or equal to 40 participated in clinical interviews. Of those who were interviewed, 7 patients (23%) were confirmed to have major depression. Overall, the prevalence of major depression was 7 of 60 patients (12%; 95% CI: 5%-23%). The ZSDS and FACT-G scores had strong correlation (r -0.75). The composite score of six statements in FACT-G were found to have sensitivity of 100% and specificity of 81% in predicting major depression, using a cut-off value of 12 (range, 0-24). The six statements were, I have a lack of energy; I feel sad; I feel nervous; I am able to enjoy life; I am sleeping well; and I am enjoying the things I usually do for fun.
Conclusions: The prevalence of major depression among all participants was 12%. The ZSDS score and FACT-G score had strong correlation; the subsets of FACT-G may be useful as a screening tool for depression.
*For a PDF of the full article, click on the link to the left of this introduction.
Objective: Although depression is prevalent among cancer patients, it remains underdiagnosed and undertreated. Quality of life is an important outcome in cancer patients and can be measured by questionnaires such as the Functional Assessment of Cancer Therapy-General version (FACT-G). The purpose of our study was to establish whether or not a group of items in FACT-G could be used as a screening tool for depression as well as for assessing quality of life.
Methods: A total of 62 chemotherapy patients (median age, 62 years [range, 22-81 years]; 55% women) completed Zung Self-Rating Depression Scale (ZSDS) and FACT-G questionnaires. Patients with ZSDS scores of 40 or more underwent clinical interviews for major depression. Pearson’s correlation was used to examine the relationship between the ZSDS and FACT-G scores. FACT-G score results were then analyzed to evaluate if subsets of the FACT-G can be used as a screening tool for major depression.
Results: In all, 30 of 62 patients (48%) had ZSDS scores less than 40 and were ruled out for major depression, and 30 of the 32 patients with ZSDS scores greater or equal to 40 participated in clinical interviews. Of those who were interviewed, 7 patients (23%) were confirmed to have major depression. Overall, the prevalence of major depression was 7 of 60 patients (12%; 95% CI: 5%-23%). The ZSDS and FACT-G scores had strong correlation (r -0.75). The composite score of six statements in FACT-G were found to have sensitivity of 100% and specificity of 81% in predicting major depression, using a cut-off value of 12 (range, 0-24). The six statements were, I have a lack of energy; I feel sad; I feel nervous; I am able to enjoy life; I am sleeping well; and I am enjoying the things I usually do for fun.
Conclusions: The prevalence of major depression among all participants was 12%. The ZSDS score and FACT-G score had strong correlation; the subsets of FACT-G may be useful as a screening tool for depression.
*For a PDF of the full article, click on the link to the left of this introduction.
Depression and Quality of Life in Cancer Patients Undergoing Chemotherapy: Relation between the Zung Self-Rating Depression Scale and Functional Assessment of Cancer Therapy-General
Display Headline
Depression and Quality of Life in Cancer Patients Undergoing Chemotherapy: Relation between the Zung Self-Rating Depression Scale and Functional Assessment of Cancer Therapy-General
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Original research
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Previous Presentation: Presented in part at the annual meeting of the American Society of Clinical Oncology, Orlando, Florida, May 29–June 2, 2009.
Luigi Celio, MD
,
Angela Denaro, MD,
Francesco Agustoni, MD,
Emilio Bajetta, MD
Department of Medical Oncology, Fondazione IRCCS “Istituto Nazionale Tumori,” Milan, Italy
Received 11 February 2011. Accepted 16 June 2011. Available online 23 September 2011.
The non-inferiority of palonosetron plus 1-day versus 3-day dexamethasone in preventing chemotherapy-induced nausea and vomiting (CINV) due to moderately emetogenic chemotherapy (MEC) has been previously demonstrated.
Objective
The objectives of this prespecified post hoc analysis were to demonstrate the non-inferiority hypothesis in an adjusted model for known risk factors (age, gender, alcohol consumption, and type of MEC [anthracycline plus cyclophosphamide (AC)–based versus other MEC]) for CINV and to explore the impact on antiemetic outcome of these risk factors.
Methods
Chemonaive patients (n = 324) with solid tumors were randomized to receive palonosetron 0.25 mg IV plus dexamethasone 8 mg IV on day 1 of chemotherapy or the same regimen followed by oral dexamethasone 8 mg on days 2 and 3. The primary end point was complete response (CR, no emesis and no rescue antiemetics) during the 5-day study period. A modified intention-to-treat approach was used for multivariable analysis.
Results
Non-inferiority of the 1-day regimen was confirmed even after adjusting for risk factors (risk difference −4.4%, 95% CI −14.1% to 5.4%; P = .381). Only age less than 50 years (P = .044) independently predicted a poor outcome of antiemetic treatment. However, most of the younger patients were women (1-day regimen 81.8%, 3-day regimen 88.4%) who underwent AC-based chemotherapy (1-day regimen 61.1%, 3-day regimen 71.0%). There were no significant between-treatment differences in the CR rate according to risk factors.
Conclusion
This analysis confirmed that the 1-day regimen provides a valid treatment option for prevention of CINV in delayed, non-AC-based MEC.
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Previous Presentation: Presented in part at the annual meeting of the American Society of Clinical Oncology, Orlando, Florida, May 29–June 2, 2009.
Luigi Celio, MD
,
Angela Denaro, MD,
Francesco Agustoni, MD,
Emilio Bajetta, MD
Department of Medical Oncology, Fondazione IRCCS “Istituto Nazionale Tumori,” Milan, Italy
Received 11 February 2011. Accepted 16 June 2011. Available online 23 September 2011.
The non-inferiority of palonosetron plus 1-day versus 3-day dexamethasone in preventing chemotherapy-induced nausea and vomiting (CINV) due to moderately emetogenic chemotherapy (MEC) has been previously demonstrated.
Objective
The objectives of this prespecified post hoc analysis were to demonstrate the non-inferiority hypothesis in an adjusted model for known risk factors (age, gender, alcohol consumption, and type of MEC [anthracycline plus cyclophosphamide (AC)–based versus other MEC]) for CINV and to explore the impact on antiemetic outcome of these risk factors.
Methods
Chemonaive patients (n = 324) with solid tumors were randomized to receive palonosetron 0.25 mg IV plus dexamethasone 8 mg IV on day 1 of chemotherapy or the same regimen followed by oral dexamethasone 8 mg on days 2 and 3. The primary end point was complete response (CR, no emesis and no rescue antiemetics) during the 5-day study period. A modified intention-to-treat approach was used for multivariable analysis.
Results
Non-inferiority of the 1-day regimen was confirmed even after adjusting for risk factors (risk difference −4.4%, 95% CI −14.1% to 5.4%; P = .381). Only age less than 50 years (P = .044) independently predicted a poor outcome of antiemetic treatment. However, most of the younger patients were women (1-day regimen 81.8%, 3-day regimen 88.4%) who underwent AC-based chemotherapy (1-day regimen 61.1%, 3-day regimen 71.0%). There were no significant between-treatment differences in the CR rate according to risk factors.
Conclusion
This analysis confirmed that the 1-day regimen provides a valid treatment option for prevention of CINV in delayed, non-AC-based MEC.
Original research
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Previous Presentation: Presented in part at the annual meeting of the American Society of Clinical Oncology, Orlando, Florida, May 29–June 2, 2009.
Luigi Celio, MD
,
Angela Denaro, MD,
Francesco Agustoni, MD,
Emilio Bajetta, MD
Department of Medical Oncology, Fondazione IRCCS “Istituto Nazionale Tumori,” Milan, Italy
Received 11 February 2011. Accepted 16 June 2011. Available online 23 September 2011.
The non-inferiority of palonosetron plus 1-day versus 3-day dexamethasone in preventing chemotherapy-induced nausea and vomiting (CINV) due to moderately emetogenic chemotherapy (MEC) has been previously demonstrated.
Objective
The objectives of this prespecified post hoc analysis were to demonstrate the non-inferiority hypothesis in an adjusted model for known risk factors (age, gender, alcohol consumption, and type of MEC [anthracycline plus cyclophosphamide (AC)–based versus other MEC]) for CINV and to explore the impact on antiemetic outcome of these risk factors.
Methods
Chemonaive patients (n = 324) with solid tumors were randomized to receive palonosetron 0.25 mg IV plus dexamethasone 8 mg IV on day 1 of chemotherapy or the same regimen followed by oral dexamethasone 8 mg on days 2 and 3. The primary end point was complete response (CR, no emesis and no rescue antiemetics) during the 5-day study period. A modified intention-to-treat approach was used for multivariable analysis.
Results
Non-inferiority of the 1-day regimen was confirmed even after adjusting for risk factors (risk difference −4.4%, 95% CI −14.1% to 5.4%; P = .381). Only age less than 50 years (P = .044) independently predicted a poor outcome of antiemetic treatment. However, most of the younger patients were women (1-day regimen 81.8%, 3-day regimen 88.4%) who underwent AC-based chemotherapy (1-day regimen 61.1%, 3-day regimen 71.0%). There were no significant between-treatment differences in the CR rate according to risk factors.
Conclusion
This analysis confirmed that the 1-day regimen provides a valid treatment option for prevention of CINV in delayed, non-AC-based MEC.
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Display Headline
Palonosetron Plus 1-Day Dexamethasone for the Prevention of Nausea and Vomiting Due to Moderately Emetogenic Chemotherapy: Effect of Established Risk Factors on Treatment Outcome in a Phase III Trial
Spiritual Well-Being and Quality of Life of Women with Ovarian Cancer and Their Spouses
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later.
Original research
Spiritual Well-Being and Quality of Life of Women with Ovarian Cancer and Their Spouses
There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses.
Objective
We compared the SWB and QOL of these women and their spouses over a 3-year period.
Methods
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later. All participants completed the Functional Assessment of Chronic Illness Therapy (FACIT)–Spiritual Well-Being–Expanded Version, Symptom Distress Scale, and open-ended questions about changes in their lives. Diagnosed women completed the FACIT-Ovarian and spouses the Caregiver Burden Interview and Linear Analog Self-Assessment scales.
Results
Women reported a high level of SWB over time. Spouses' SWB was significantly worse than the women's at 1 and 3 years (P ≤ .05). Insomnia, fatigue, and outlook/worry were problematic across time, with no significant differences between women and spouses except that women experienced more insomnia through 3 months (P = .02). Emotional well-being was compromised over time for the women but not their spouses until year 3. Physical and social well-being were compromised in spouses across time, while women's social well-being remained high and physical well-being was problematic only for the first year.
Limitations
Limitations include a small spouse sample and, due to the disease process, attrition over time.
Conclusions
Ovarian cancer has significant, but different, effects on women and spouses. Some effects are static, while others are not, which underscores the need for continual monitoring.
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later.
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later.
Original research
Spiritual Well-Being and Quality of Life of Women with Ovarian Cancer and Their Spouses
There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses.
Objective
We compared the SWB and QOL of these women and their spouses over a 3-year period.
Methods
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later. All participants completed the Functional Assessment of Chronic Illness Therapy (FACIT)–Spiritual Well-Being–Expanded Version, Symptom Distress Scale, and open-ended questions about changes in their lives. Diagnosed women completed the FACIT-Ovarian and spouses the Caregiver Burden Interview and Linear Analog Self-Assessment scales.
Results
Women reported a high level of SWB over time. Spouses' SWB was significantly worse than the women's at 1 and 3 years (P ≤ .05). Insomnia, fatigue, and outlook/worry were problematic across time, with no significant differences between women and spouses except that women experienced more insomnia through 3 months (P = .02). Emotional well-being was compromised over time for the women but not their spouses until year 3. Physical and social well-being were compromised in spouses across time, while women's social well-being remained high and physical well-being was problematic only for the first year.
Limitations
Limitations include a small spouse sample and, due to the disease process, attrition over time.
Conclusions
Ovarian cancer has significant, but different, effects on women and spouses. Some effects are static, while others are not, which underscores the need for continual monitoring.
Original research
Spiritual Well-Being and Quality of Life of Women with Ovarian Cancer and Their Spouses
There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses.
Objective
We compared the SWB and QOL of these women and their spouses over a 3-year period.
Methods
This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later. All participants completed the Functional Assessment of Chronic Illness Therapy (FACIT)–Spiritual Well-Being–Expanded Version, Symptom Distress Scale, and open-ended questions about changes in their lives. Diagnosed women completed the FACIT-Ovarian and spouses the Caregiver Burden Interview and Linear Analog Self-Assessment scales.
Results
Women reported a high level of SWB over time. Spouses' SWB was significantly worse than the women's at 1 and 3 years (P ≤ .05). Insomnia, fatigue, and outlook/worry were problematic across time, with no significant differences between women and spouses except that women experienced more insomnia through 3 months (P = .02). Emotional well-being was compromised over time for the women but not their spouses until year 3. Physical and social well-being were compromised in spouses across time, while women's social well-being remained high and physical well-being was problematic only for the first year.
Limitations
Limitations include a small spouse sample and, due to the disease process, attrition over time.
Conclusions
Ovarian cancer has significant, but different, effects on women and spouses. Some effects are static, while others are not, which underscores the need for continual monitoring.
National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients' religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the relationships of these variables to quality of life (QOL); and assess patients' perceptions of spiritual care in the cancer care setting.
Methods
This is a multisite, cross-sectional survey of 69 patients with advanced cancer (response rate = 73%) receiving palliative RT. Scripted interviews assessed patient spirituality, religiousness, religious coping, QOL (McGill QOL Questionnaire), and perceptions of the importance of attention to spiritual needs by health providers. Multivariable models assessed the relationships of patient spirituality and R/S coping to patient QOL, controlling for other significant predictors of QOL.
Results
Most participants (84%) indicated reliance on R/S beliefs to cope with cancer. Patient spirituality and religious coping were associated with improved QOL in multivariable analyses (β = 10.57, P < .001 and β = 1.28, P = .01, respectively). Most patients considered attention to spiritual concerns an important part of cancer care by physicians (87%) and nurses (85%).
Limitations
Limitations include a small sample size, a cross-sectional study design, and a limited proportion of nonwhite participants (15%) from one US region.
Conclusion
Patients receiving palliative RT rely on R/S beliefs to cope with advanced cancer. Furthermore, spirituality and religious coping are contributors to better QOL. These findings highlight the importance of spiritual care in advanced cancer care.
*For a PDF of the full article click in the link to the left of this introduction.
National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients' religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the relationships of these variables to quality of life (QOL); and assess patients' perceptions of spiritual care in the cancer care setting.
Methods
This is a multisite, cross-sectional survey of 69 patients with advanced cancer (response rate = 73%) receiving palliative RT. Scripted interviews assessed patient spirituality, religiousness, religious coping, QOL (McGill QOL Questionnaire), and perceptions of the importance of attention to spiritual needs by health providers. Multivariable models assessed the relationships of patient spirituality and R/S coping to patient QOL, controlling for other significant predictors of QOL.
Results
Most participants (84%) indicated reliance on R/S beliefs to cope with cancer. Patient spirituality and religious coping were associated with improved QOL in multivariable analyses (β = 10.57, P < .001 and β = 1.28, P = .01, respectively). Most patients considered attention to spiritual concerns an important part of cancer care by physicians (87%) and nurses (85%).
Limitations
Limitations include a small sample size, a cross-sectional study design, and a limited proportion of nonwhite participants (15%) from one US region.
Conclusion
Patients receiving palliative RT rely on R/S beliefs to cope with advanced cancer. Furthermore, spirituality and religious coping are contributors to better QOL. These findings highlight the importance of spiritual care in advanced cancer care.
*For a PDF of the full article click in the link to the left of this introduction.
Original research
The Role of Spirituality and Religious Coping in the Quality of Life of Patients With Advanced Cancer Receiving Palliative Radiation Therapy
National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients' religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the relationships of these variables to quality of life (QOL); and assess patients' perceptions of spiritual care in the cancer care setting.
Methods
This is a multisite, cross-sectional survey of 69 patients with advanced cancer (response rate = 73%) receiving palliative RT. Scripted interviews assessed patient spirituality, religiousness, religious coping, QOL (McGill QOL Questionnaire), and perceptions of the importance of attention to spiritual needs by health providers. Multivariable models assessed the relationships of patient spirituality and R/S coping to patient QOL, controlling for other significant predictors of QOL.
Results
Most participants (84%) indicated reliance on R/S beliefs to cope with cancer. Patient spirituality and religious coping were associated with improved QOL in multivariable analyses (β = 10.57, P < .001 and β = 1.28, P = .01, respectively). Most patients considered attention to spiritual concerns an important part of cancer care by physicians (87%) and nurses (85%).
Limitations
Limitations include a small sample size, a cross-sectional study design, and a limited proportion of nonwhite participants (15%) from one US region.
Conclusion
Patients receiving palliative RT rely on R/S beliefs to cope with advanced cancer. Furthermore, spirituality and religious coping are contributors to better QOL. These findings highlight the importance of spiritual care in advanced cancer care.
*For a PDF of the full article click in the link to the left of this introduction.
Background Little is known about the impact of myelodysplastic syndromes (MDS) on the quality of life (QoL) of those living with the disease.
Objectives To explore the impact of MDS on the quality of life of those living with the disease.
Methods Seventy patients with MDS participated in five focus groups conducted throughout the United States. Transcripts from recordings of focus group sessions were coded and emerging themes identified using thematic analysis.
Results Findings revealed a multifaceted description of how MDS affects QoL. MDS was found to cause a substantial and sustained decrease in ability to function. QoL was adversely affected by work expended on managing the disease. The emotional impact was often viewed as more problematic than the physical impact; emotional reactions included shock, anger, depression, and anxiety. In contrast, spiritual well-being was often enhanced, with a renewed appreciation for life, relationships, and faith.
Limitations The method of subject recruitment may have limited participation to individuals who are more proactive in obtaining information about their illness. The focus groups convened only once, thus purposive sampling and repeated assessments were not possible.
Conclusions MDS has a substantial, often negative impact on patients' lives and clinicians should be cognizant of this impact. Attention must be directed at providing more comprehensive support for the patient throughout the illness trajectory.
Click on the PDF icon at the top of this introduction to read the full article.
Background Little is known about the impact of myelodysplastic syndromes (MDS) on the quality of life (QoL) of those living with the disease.
Objectives To explore the impact of MDS on the quality of life of those living with the disease.
Methods Seventy patients with MDS participated in five focus groups conducted throughout the United States. Transcripts from recordings of focus group sessions were coded and emerging themes identified using thematic analysis.
Results Findings revealed a multifaceted description of how MDS affects QoL. MDS was found to cause a substantial and sustained decrease in ability to function. QoL was adversely affected by work expended on managing the disease. The emotional impact was often viewed as more problematic than the physical impact; emotional reactions included shock, anger, depression, and anxiety. In contrast, spiritual well-being was often enhanced, with a renewed appreciation for life, relationships, and faith.
Limitations The method of subject recruitment may have limited participation to individuals who are more proactive in obtaining information about their illness. The focus groups convened only once, thus purposive sampling and repeated assessments were not possible.
Conclusions MDS has a substantial, often negative impact on patients' lives and clinicians should be cognizant of this impact. Attention must be directed at providing more comprehensive support for the patient throughout the illness trajectory.
Click on the PDF icon at the top of this introduction to read the full article.
Background Little is known about the impact of myelodysplastic syndromes (MDS) on the quality of life (QoL) of those living with the disease.
Objectives To explore the impact of MDS on the quality of life of those living with the disease.
Methods Seventy patients with MDS participated in five focus groups conducted throughout the United States. Transcripts from recordings of focus group sessions were coded and emerging themes identified using thematic analysis.
Results Findings revealed a multifaceted description of how MDS affects QoL. MDS was found to cause a substantial and sustained decrease in ability to function. QoL was adversely affected by work expended on managing the disease. The emotional impact was often viewed as more problematic than the physical impact; emotional reactions included shock, anger, depression, and anxiety. In contrast, spiritual well-being was often enhanced, with a renewed appreciation for life, relationships, and faith.
Limitations The method of subject recruitment may have limited participation to individuals who are more proactive in obtaining information about their illness. The focus groups convened only once, thus purposive sampling and repeated assessments were not possible.
Conclusions MDS has a substantial, often negative impact on patients' lives and clinicians should be cognizant of this impact. Attention must be directed at providing more comprehensive support for the patient throughout the illness trajectory.
Click on the PDF icon at the top of this introduction to read the full article.
