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Cancers
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Quality of Life in Cancer Rehabilitation
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Quality of Life in Cancer Rehabilitation

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

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Editors

Prof. Dr. Thomas Licht

E-Mail Website
Collection Editor
Ludwig Boltzmann Institute for Rehabilitation Research, Kurbadstraße 14, 1100 Vienna, Austria
Interests: cancer rehabilitation; supportive care of cancer; outcome research; psycho-oncology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Richard Crevenna

E-Mail Website
Collection Editor
Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
Interests: side effects management; supportive care & cancer rehabilitation; prehabilitation; exercise
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

Many cancer survivors suffer from cancer-related symptoms, or adverse effects of surgery, radiotherapy or chemotherapy. These impairments include fatigue, pain, decreased muscular strength and endurance, lymphedema, weight loss, gastrointestinal symptoms, cognitive deficits, and chemotherapy-induced peripheral neuropathy. Thus, activities and participation can become permanently impaired. Some patients cannot return to work after cancer treatment or become dependent on care. Furthermore, psychological distress is common among cancer survivors, mainly depression and fear of cancer progression.

Cancer rehabilitation is aimed at improving cancer survivors’ quality of life by alleviation of these symptoms. It should also improve coping with cancer and help to develop strategies for resilience. To this end, physical therapies, exercise interventions, psycho-educative and emotionally supportive treatment modalities, and art and expression are combined in a multidisciplinary fashion. Other interventions include educational lectures on nutrition and lifestyle interventions for reduction of risk-factors such as smoking.

Rehabilitation can be performed as an inpatient or outpatient measure. In the Topical Collection, “Quality of Life in Cancer Rehabilitation”, an overview on current rehabilitative strategies is provided. Recent research on the efficacy of rehabilitation for sustained improvement of health-related quality of life is reported.

Prof. Dr. Thomas Licht
Prof. Dr. Richard Crevenna
Collection 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. 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 collection 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 2600 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

  • cancer-related symptoms
  • cancer rehabilitation
  • physical therapy
  • medical psycho-oncology
  • depression
  • anxiety
  • fatigue
  • patient-reported outcomes

Published Papers (19 papers)

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2023

Jump to: 2022, 2021

17 pages, 445 KiB  
Review
Wellbeing and Complementary Therapies in Breast Cancer Peripheral Neuropathy Care: A Scoping Review Focused on Foot Health
by Raquel Veiga-Seijo, Maria Eva Perez-Lopez, Uxia Fernandez-Lopez, Abian Mosquera-Fernandez, Rocio Seijo-Bestilleiro and Cristina Gonzalez-Martin
Cancers 2023, 15(7), 2110; https://doi.org/10.3390/cancers15072110 - 31 Mar 2023
Cited by 2 | Viewed by 1797
Abstract
Background: Chemotherapy-induced peripheral neuropathy is a multidimensional health problem. Up to now, little evidence has been found concerning its impact on quality of life and foot health. Evaluation tools and prevention and treatment strategies must be reported. This study aimed to map the [...] Read more.
Background: Chemotherapy-induced peripheral neuropathy is a multidimensional health problem. Up to now, little evidence has been found concerning its impact on quality of life and foot health. Evaluation tools and prevention and treatment strategies must be reported. This study aimed to map the literature on the impact of this side effect on the wellbeing and foot health of people with breast cancer and to describe their main assessment strategies and complementary therapies. Methods: A scoping review was carried out while following the PRISMA-ScR and Arksey and O’Malley guidelines. Different databases (Cochrane Plus, Scopus, Web of Science, and Pubmed) were used. A total of 221 results were identified. Sixteen articles were included. Results: The thematic analysis obtained the following categories: the impact of peripheral neuropathy on quality of life and foot health, complementary therapies as a path for new strategies, and the need for clinicians and researchers to get involved in researching this side effect. Conclusions: Peripheral neuropathy has a negative impact on people’s quality of life. Implications for foot health and maintaining an active and healthy lifestyle have not been previously reported. Complementary therapies are recommended by scientific evidence, highlighting exercise. However, there is a need to develop more research that will help to incorporate them into evidence-based practice. Full article
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24 pages, 510 KiB  
Article
Associations of Age and Sex with the Efficacy of Inpatient Cancer Rehabilitation: Results from a Longitudinal Observational Study Using Electronic Patient-Reported Outcomes
by Jens Lehmann, David Riedl, Alain Nickels, Gabriele Sanio, Marco Hassler, Gerhard Rumpold, Bernhard Holzner and Thomas Licht
Cancers 2023, 15(6), 1637; https://doi.org/10.3390/cancers15061637 - 07 Mar 2023
Cited by 3 | Viewed by 1596
Abstract
Cancer rehabilitation is thought to increase the quality of life (QOL) and functioning of cancer survivors. It remains, however, uncertain whether subgroups benefit equally from rehabilitation. We wished to investigate the outcomes of multimodal rehabilitation according to age, sex and functioning. Patients of [...] Read more.
Cancer rehabilitation is thought to increase the quality of life (QOL) and functioning of cancer survivors. It remains, however, uncertain whether subgroups benefit equally from rehabilitation. We wished to investigate the outcomes of multimodal rehabilitation according to age, sex and functioning. Patients of an Austrian rehabilitation center routinely completed the EORTC QLQ-C30 and the hospital anxiety and depression scale (HADS) questionnaires prior to (T1), and after rehabilitation (T2). To compare the outcomes between age groups (i.e., <40, 41–69, and ≥70 years), sex, and the Norton scale risk status, repeated measures of analyses of variance were calculated. A total of 5567 patients with an average age of 60.7 years were included, of which 62.7% were female. With T1 indicating the cancer survivors’ needs, older and high-risk patients reported lower functioning (all p < 0.001) and a higher symptom burden for most scales (all p < 0.05) before rehabilitation. Regardless of age, sex or risk status, the patients showed at a least small to medium improvement during rehabilitation for anxiety, depression, and most functioning and symptom scales. Some between-group differences were observed, none of which being of a relevant effect size as determined with the Cohen’s d. In conclusion, QOL is improved by rehabilitation in all patients groups, independently from age, sex, or the risk status. Full article
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9 pages, 261 KiB  
Viewpoint
Prescribing Exercise to Cancer Patients Suffering from Increased Bone Fracture Risk Due to Metastatic Bone Disease or Multiple Myeloma in Austria—An Inter- and Multidisciplinary Evaluation Measure
by Richard Crevenna, Timothy Hasenoehrl, Christoph Wiltschke, Franz Kainberger and Mohammad Keilani
Cancers 2023, 15(4), 1245; https://doi.org/10.3390/cancers15041245 - 15 Feb 2023
Viewed by 1343
Abstract
Introduction: In the current absence of specific functional fracture risk assessment technology, the planning of physical exercise interventions for cancer patients suffering from increased bone fracture risk remains a serious clinical challenge. Until a reliable, solely technical solution is available for the clinician, [...] Read more.
Introduction: In the current absence of specific functional fracture risk assessment technology, the planning of physical exercise interventions for cancer patients suffering from increased bone fracture risk remains a serious clinical challenge. Until a reliable, solely technical solution is available for the clinician, fracture risk assessment remains an inter- and multidisciplinary decision to be made by various medical experts. The aim of this short paper is depicting how this challenge should be approached in the clinical reality according to Austrian experts in cancer rehabilitation, presenting the best-practice model in Austria. Following referral from the specialist responsible for the primary cancer treatment (oncologist, surgeon, etc.), the physiatrist takes on the role of rehabilitation case manager for each individual patient. Fracture risk assessment is then undertaken by specialists in radiology, orthopedics, oncology, and radiation therapy, with the result that the affected bone regions are classified as being at highly/slightly/not increased fracture risk. Following internal clearance, exercise planning is undertaken by a specialist in exercise therapy together with the physiatrist based on the individual’s fracture risk assessment. In the case in which the patient shows exercise limitations due to additional musculoskeletal impairments, adjuvant physical modalities such as physiotherapy should be prescribed to increase exercisability. Conclusion: Exercise prescription for cancer patients suffering from increased fracture risk is an inter- and multidisciplinary team decision for each individual patient. Full article
8 pages, 522 KiB  
Article
Tolerability, Safety and Efficacy of a Specific Rehabilitation Treatment Protocol for Axillary Web Syndrome: An Observational Retrospective Study
by Margherita Beatrice Borg, Laura Mittino, Marco Battaglia, Alberto Loro, Laura Lanzotti, Marco Invernizzi and Alessio Baricich
Cancers 2023, 15(2), 426; https://doi.org/10.3390/cancers15020426 - 09 Jan 2023
Cited by 1 | Viewed by 1636
Abstract
Axillary web syndrome (AWS) is a highly prevalent surgical complication affecting BC survivors. It presents as a subcutaneous cording that limits the upper limb range of motion (ROM) and causes pain. Its etiology is still debated, and its treatment is not well defined. [...] Read more.
Axillary web syndrome (AWS) is a highly prevalent surgical complication affecting BC survivors. It presents as a subcutaneous cording that limits the upper limb range of motion (ROM) and causes pain. Its etiology is still debated, and its treatment is not well defined. Therefore, we aimed to investigate the safety, tolerability and efficacy of our specific AWS rehabilitative treatment protocol. We conducted an observational retrospective study on a cohort of 92 AWS patients referred to the oncological outpatient service of a university hospital. We collected data from medical records before (T0) and after (T1) the treatment. The studied protocol was composed of 60-min sessions, carried out 3 times/week by specialized physiotherapists, until the clinical resolution of AWS. We found that a mean of 8.74 ± 2.12 rehabilitative sessions were needed, and only one patient stopped early. At T1, shoulder ROM was complete in both abduction and flexion in 98% of patients; AWS was no longer detectable in 64% of them, and pain significantly decreased compared to T0. In conclusion, our protocol proved to be safe, well-tolerated and seemed to be effective in treating AWS. Full article
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2022

Jump to: 2023, 2021

17 pages, 305 KiB  
Article
Understanding Inequalities in the Uptake of Supportive Care to Improve Practices in the Cancer Care Continuum
by Jade Gourret Baumgart, Hélène Kane, Sylvie Pelletier, Karine André, Catherine Barbe, Thierry Lecomte, Yacine Sam, Nizar Messai, Emmanuel Rusch and Frédéric Denis
Cancers 2022, 14(24), 6053; https://doi.org/10.3390/cancers14246053 - 08 Dec 2022
Viewed by 1250
Abstract
(1) Background: While inequalities in the prevalence of cancer, access to care, and survival have been well documented, less research has focused on inequalities in the uptake of supportive oncology care. Given its contribution to improving the quality of life of people affected [...] Read more.
(1) Background: While inequalities in the prevalence of cancer, access to care, and survival have been well documented, less research has focused on inequalities in the uptake of supportive oncology care. Given its contribution to improving the quality of life of people affected by cancer, access to such care is a major public health issue. The present study focuses on the access and uptake of those supportive oncology care services. (2) Methods: This study is based on qualitative research methodology, using a thematic analysis tree on NVivo© analysis software. First, an exploratory survey was conducted with users of oncology services, and professionals from these services and supportive oncology care. Then, individual interviews were conducted in June 2022 among people who are currently being treated or have been treated for cancer. (3) Results: The experiences of the 33 respondents revealed that significant variations in the uptake of supportive oncology care are underpinned by identifiable disparities in their healthcare pathways: in their assimilation of information, difficulties in accessing oncology care, personal reluctance and motivations, perceived needs and benefits, and use of other medicines. (4) Conclusion: This study aims to gain some insight into disparities in the uptake of supportive care in the Centre-Val de Loire region (France). Thus, it provides a better understanding of the complex ways in which these inequalities in supportive oncology care uptake are constructed. Full article
16 pages, 934 KiB  
Article
Large Improvements in Health-Related Quality of Life and Physical Fitness during Multidisciplinary Inpatient Rehabilitation for Pediatric Cancer Survivors
by David Riedl, Thomas Licht, Alain Nickels, Maria Rothmund, Gerhard Rumpold, Bernhard Holzner, Vincent Grote, Michael J. Fischer and Gustav Fischmeister
Cancers 2022, 14(19), 4855; https://doi.org/10.3390/cancers14194855 - 04 Oct 2022
Cited by 3 | Viewed by 1802
Abstract
Rehabilitation is a key element in improving health-related quality of life (HRQOL) for pediatric cancer survivors. The aim of this study was to present data from a multidisciplinary inpatient rehabilitation treatment. Children took part in a four-week multidisciplinary family-oriented inpatient rehabilitation. A total [...] Read more.
Rehabilitation is a key element in improving health-related quality of life (HRQOL) for pediatric cancer survivors. The aim of this study was to present data from a multidisciplinary inpatient rehabilitation treatment. Children took part in a four-week multidisciplinary family-oriented inpatient rehabilitation. A total of 236 children (>5–21 years) and 478 parents routinely completed electronic patient-reported outcomes (ePROs), performance-based assessments, and clinician-rated assessments before (T1) and at the end (T2) of rehabilitation. HRQOL was assessed with the PedsQL generic core and PedsQL cancer module. Data were analyzed using repeated measures analysis of variance (ANOVA). Statistically significant improvements with medium to large effect sizes were observed for most HRQOL scales (η2 = 0.09–0.31), as well as performance-based and clinician-rated assessments for physical activity and functional status (η2 > 0.28). Agreement between children’s PROs and parents’ proxy ratings was lower before (rICC = 0.72) than after (rICC = 0.86) rehabilitation. While the concordance between children and parents’ assessment of changes during rehab was low to moderate (r = 0.19–0.59), the use of the performance score led to substantially increased scores (r = 0.29–0.68). The results of this naturalistic observational study thus highlight the benefits of multidisciplinary pediatric inpatient rehabilitation for childhood cancer survivors. The use of the performance score is recommended in this field. Full article
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29 pages, 5987 KiB  
Systematic Review
Digital and Interactive Health Interventions Minimize the Physical and Psychological Impact of Breast Cancer, Increasing Women’s Quality of Life: A Systematic Review and Meta-Analysis
by Esteban Obrero-Gaitán, Irene Cortés-Pérez, Tania Calet-Fernández, Héctor García-López, María del Carmen López Ruiz and María Catalina Osuna-Pérez
Cancers 2022, 14(17), 4133; https://doi.org/10.3390/cancers14174133 - 26 Aug 2022
Cited by 6 | Viewed by 2434
Abstract
Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect [...] Read more.
Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect of DIHIs on improving pain, anxiety, depression, quality of life (QoL), and upper extremity (UE) disability-related lymphedema in women with BC. Methods: We searched PubMed Medline, Web of Science, Scopus, CINAHL, Physiotherapy Evidence Database, and SciELO for the period ending February 2022. We included studies that assessed the effect of DIHIs on UE motor disability, pain, anxiety, depression, and QoL in women with BC. The effect size was calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Twenty studies providing data from 1613 women with BC were included. With respect to UE disability, DIHIs increased flexion (SMD, 1.92; 95%CI: −1.16, 2.68), abduction (SMD, 1.66; 95%CI: 0.91, 2.42), external rotation shoulder range of motion (SMD, 1.1; 95%CI: 0.36, 1.85), UE function (SMD, −0.72; 95%CI: −1.31, −0.13), and handgrip strength (SMD, 0.4; 95%CI: 0.21, 0.59). DIHIs reduced pain (SMD, −0.8; 95%CI: −1.31, −0.26), anxiety (SMD, −1.02; 95%CI: −1.71, −0.34), and depression (SMD, −1.57; 95%CI: −3.1, −0.08). Finally, DIHIs increased overall health (SMD, 0.6; 95%CI: 0.31, 0.89). Conclusions: Right at the end of therapy, DIHIs are effective at improving UE function, pain, anxiety, depression, and QoL in women with BC. VRBT has a greater effect than SABT for the assessed outcomes. Full article
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14 pages, 609 KiB  
Article
Return to Work, Fatigue and Cancer Rehabilitation after Curative Radiotherapy and Radiochemotherapy for Pelvic Gynecologic Cancer
by Eva Meixner, Elisabetta Sandrini, Line Hoeltgen, Tanja Eichkorn, Philipp Hoegen, Laila König, Nathalie Arians, Jonathan W. Lischalk, Markus Wallwiener, Ilse Weis, Daniela Roob, Jürgen Debus and Juliane Hörner-Rieber
Cancers 2022, 14(9), 2330; https://doi.org/10.3390/cancers14092330 - 08 May 2022
Cited by 3 | Viewed by 2274
Abstract
Pain, fatigue, and depression are a common cluster of symptoms among cancer patients that impair quality of life and daily activities. We aimed to evaluate the burden of cancer rehabilitation and return-to-work (RTW) rates. Tumor characteristics, lifestyle and household details, treatment data, the [...] Read more.
Pain, fatigue, and depression are a common cluster of symptoms among cancer patients that impair quality of life and daily activities. We aimed to evaluate the burden of cancer rehabilitation and return-to-work (RTW) rates. Tumor characteristics, lifestyle and household details, treatment data, the use of in-house social services and post-treatment inpatient rehabilitation, and RTW were assessed for 424 women, diagnosed with cervical, uterine, or vaginal/vulvar cancer, receiving curative radio(chemo)therapy. Progression-free RTW rate at 3 months was 32.3%, and increased to 58.1% and 63.2% at 12 and 18 months, respectively. Patients with advanced FIGO stages and intensified treatments significantly suffered more from acute pain and fatigue. A higher Charlson-Comorbidity-Index reliably predicted patients associated with a higher risk of acute fatigue during RT. Aside from the presence of children, no other household or lifestyle factor was correlated with increased fatigue rates. Women aged ≤ 45 years had a significantly higher risk of developing depression requiring treatment during follow-up. Post-treatment inpatient cancer rehabilitation, including exercise and nutrition counseling, significantly relieved fatigue symptoms. The burdens for recovery from cancer therapy remain multi-factorial. Special focus needs to be placed on identifying high-risk groups experiencing fatigue or pain. Specialized post-treatment inpatient cancer rehabilitation can improve RTW rates. Full article
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11 pages, 446 KiB  
Article
Importance of and Satisfaction with Domains of Health-Related Quality of Life in Cancer Rehabilitation
by Andreas Hinz, Thomas Schulte, Jochen Ernst and Anja Mehnert-Theuerkauf
Cancers 2022, 14(8), 1991; https://doi.org/10.3390/cancers14081991 - 14 Apr 2022
Cited by 1 | Viewed by 1577
Abstract
Instruments for measuring health-related quality of life (HRQoL) generally do not consider the subjective importance of the dimensions they comprise. The aims of this study were to analyze the subjectively perceived importance of the dimension of HRQoL and to investigate their relationship to [...] Read more.
Instruments for measuring health-related quality of life (HRQoL) generally do not consider the subjective importance of the dimensions they comprise. The aims of this study were to analyze the subjectively perceived importance of the dimension of HRQoL and to investigate their relationship to the satisfaction ratings with these dimensions. A total of 1108 participants enrolled in a cancer rehabilitation program were surveyed. Patients rated eight dimensions of HRQoL (physical functioning, autonomy, emotional stability, cognitive functioning, social relationships, vitality, absence of pain, and sleep quality), as well as global health in terms of how important those dimensions are to them, and how satisfied they are with them. The dimensions with the highest importance ratings were autonomy and social relationships. There were only small sex differences in the importance ratings, but younger patients rated health as being more important than older patients did. The correlations between the importance ratings and the satisfaction ratings of the specific HRQoL dimensions ranged from −0.06 to 0.40, and the correlation between importance and satisfaction for global health was 0.01. Importance ratings provide relevant information for health care professionals in addition to the HRQoL assessments in the context of cancer rehabilitation. Full article
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15 pages, 1241 KiB  
Article
Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data
by Xhyljeta Luta, Sara Colomer-Lahiguera, Rodrigo Jose Martins Cardoso, Frank Hof, Manon Savoie, Cosette Schuler, Justine Wicht, Nadia Fucina, Patricia Debarge, Françoise Ninane, Jean Bourhis and Manuela Eicher
Cancers 2022, 14(5), 1227; https://doi.org/10.3390/cancers14051227 - 26 Feb 2022
Cited by 1 | Viewed by 2063
Abstract
Background: Head and neck cancer (HNC) patients experience distressing symptoms that can significantly impact their health-related quality of life (HRQoL). We analyzed the implementation of a nurse-led consultation (NLC) and explored potential associations with symptom burden in HNC patients. Methods: We retrospectively analyzed [...] Read more.
Background: Head and neck cancer (HNC) patients experience distressing symptoms that can significantly impact their health-related quality of life (HRQoL). We analyzed the implementation of a nurse-led consultation (NLC) and explored potential associations with symptom burden in HNC patients. Methods: We retrospectively analyzed routinely collected data to describe the implementation of the nurse-led interventions and the evolution of the M.D. Anderson Symptom Inventory scores as patient-reported outcome measures (PROMs). Patients who received routine care (n = 72) were compared with patients in the NLC group (n = 62) at a radiation oncology unit between 2017 and 2019. PROMs were measured at T0 (between simulation and the first week of radiotherapy), T1 (week 3–4), and T2 (week 5–6). Results: Screening for nutrition, smoking, oral cavity status, and capacity for swallowing/chewing, but not for pain, was applied in >80% of patients in the NLC group from T0 to T1. Education (16%) and care coordination (7%) were implemented to a lesser extent. Symptom burden increased over time with no significant differences between groups. Conclusions: The nurse-led consultation was not associated with symptom burden over time. A larger implementation study including a detailed process evaluation, larger sample size, and a focus on long-term effects is needed. Full article
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11 pages, 944 KiB  
Article
Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis
by Richard Huan Xu and Dong Dong
Cancers 2022, 14(3), 607; https://doi.org/10.3390/cancers14030607 - 25 Jan 2022
Cited by 1 | Viewed by 2005
Abstract
Objective: To assess the difference between lymphoma survivors’ self- and proxy-reported health-related quality of life (HRQoL) and its association with socioeconomic and health statuses. Methods: The data used in this study were obtained from a nationwide cross-sectional online survey in 2019. Information about [...] Read more.
Objective: To assess the difference between lymphoma survivors’ self- and proxy-reported health-related quality of life (HRQoL) and its association with socioeconomic and health statuses. Methods: The data used in this study were obtained from a nationwide cross-sectional online survey in 2019. Information about participants’ demographics, health status and HRQoL were collected. The propensity-score matching (PSM) method was used to control the effect of potential confounders on selection bias. A chi-squared test, one-way analysis of variance, and multiple linear regression models were used to assess the relationship between HRQoL and response type adjusted to respondents’ background characteristics. Results: Out of the total 4400 participants, data of 2350 ones were elicited for analysis after PSM process. Patients’ self-reported outcomes indicated a slightly better physical, role and emotional functioning than proxy-reported outcomes. Regression analysis showed that patients, who were older, unemployed, and who received surgery, were more likely to report a lower HRQoL. Further analysis demonstrated that proxy-reported patients who had completed treatment were more likely to report a higher HRQoL than those who were being treated. Conclusions: Our study demonstrates that the agreement between self- and proxy-reported HRQoL is low in patients with lymphoma and the heterogeneities of HRQoL among patients with different types of aggressive NHL (Non-Hodgkin’s lymphoma) is large. Differences in self- and proxy-reported HRQoL should be considered by oncologists when selecting and deciding the optimal care plan for lymphoma survivors. Full article
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18 pages, 5881 KiB  
Systematic Review
Prognostic Value of Negative Emotions on the Incidence of Breast Cancer: A Systematic Review and Meta-Analysis of 129,621 Patients with Breast Cancer
by Cong Xu, Kumar Ganesan, Xiaoyan Liu, Qiaobo Ye, Yuenshan Cheung, Dan Liu, Shaowen Zhong and Jianping Chen
Cancers 2022, 14(3), 475; https://doi.org/10.3390/cancers14030475 - 18 Jan 2022
Cited by 10 | Viewed by 2540
Abstract
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present [...] Read more.
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present study aims to provide an association between NEs and the incidence of BC with possible risk factors. A total of 9343 studies were screened; nine studies met all inclusion criteria that were considered for the meta-analysis. The qualitative studies were measured by the Newcastle-Ottawa Scale; the observational studies were included with relative risks (RR) and corresponding 95% confidence intervals (CI). Besides the NEs and BC, the possible risk factors were evaluated. We analyzed data from 129,621 women diagnosed with NEs of which 2080 women were diagnosed with BC and their follow-up year ranges were from 4–24 years. NEs were significantly (p < 0.0001) associated with a higher incidence of BC with RR = 1.59, 95% CI:1.15–2.19, with other high-risk factors including, geographical distribution, emotion types, standard diagnosis of NEs, and follow-up duration. This study suggests that NEs significantly increase the risk for the incidence of BC, which can be supportive of the prognosis of the disease. Full article
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2021

Jump to: 2023, 2022

19 pages, 1026 KiB  
Review
Clinical Outcome Assessment in Cancer Rehabilitation and the Central Role of Patient-Reported Outcomes
by Jens Lehmann, Maria Rothmund, David Riedl, Gerhard Rumpold, Vincent Grote, Michael J. Fischer and Bernhard Holzner
Cancers 2022, 14(1), 84; https://doi.org/10.3390/cancers14010084 - 24 Dec 2021
Cited by 15 | Viewed by 3716
Abstract
The aim of cancer rehabilitation is to help patients regain functioning and social participation. In order to evaluate and optimize rehabilitation, it is important to measure its outcomes in a structured way. In this article, we review the different types of clinical outcome [...] Read more.
The aim of cancer rehabilitation is to help patients regain functioning and social participation. In order to evaluate and optimize rehabilitation, it is important to measure its outcomes in a structured way. In this article, we review the different types of clinical outcome assessments (COAs), including Clinician-Reported Outcomes (ClinROs), Observer-Reported Outcomes (ObsROs), Performance Outcomes (PerfOs), and Patient-Reported Outcomes (PROs). A special focus is placed on PROs, which are commonly defined as any direct report from the patient about their health condition without any interpretation by a third party. We provide a narrative review of available PRO measures (PROMs) for relevant outcomes, discuss the current state of PRO implementation in cancer rehabilitation, and highlight trends that use PROs to benchmark value-based care. Furthermore, we provide examples of PRO usage, highlight the benefits of electronic PRO (ePRO) collection, and offer advice on how to select, implement, and integrate PROs into the cancer rehabilitation setting to maximize efficiency. Full article
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14 pages, 274 KiB  
Review
Rehabilitation after Allogeneic Haematopoietic Stem Cell Transplantation: A Special Challenge
by Hartmut Bertz
Cancers 2021, 13(24), 6187; https://doi.org/10.3390/cancers13246187 - 08 Dec 2021
Cited by 6 | Viewed by 2467
Abstract
The general population is getting older and suffer more haematological malignancies despite being physically fit. These malignancies are mainly only curable via an alloHCT, and they are now carried out more frequently. Patients benefit from intensive rehabilitation earlier and may need it repeatedly [...] Read more.
The general population is getting older and suffer more haematological malignancies despite being physically fit. These malignancies are mainly only curable via an alloHCT, and they are now carried out more frequently. Patients benefit from intensive rehabilitation earlier and may need it repeatedly in cases of severe side effects (e.g., graft-versus-host disease). They can suffer many problems that other cancer patients do not experience, such as severe infections, continued immunosuppression, nutritional restrictions, acute or chronic GvHD, or organ impairments (e.g., lung, eyes). They may also encounter various associated psychological problems, e.g., feeling like a chimera. Rehabilitation centres willing to care for patients after alloHCT should have an experienced multidisciplinary team and should work in close co-operation with the primary transplant centre. Full article
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18 pages, 1048 KiB  
Review
A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment
by Philip J. Chang, Arash Asher and Sean R. Smith
Cancers 2021, 13(20), 5191; https://doi.org/10.3390/cancers13205191 - 16 Oct 2021
Cited by 21 | Viewed by 11360
Abstract
Persistent pain following treatment for breast cancer is common and often imprecisely labeled as post-mastectomy pain syndrome (PMPS). PMPS is a disorder with multiple potential underlying causes including intercostobrachial nerve injury, intercostal neuromas, phantom breast pain, and pectoralis minor syndrome. Adding further complexity [...] Read more.
Persistent pain following treatment for breast cancer is common and often imprecisely labeled as post-mastectomy pain syndrome (PMPS). PMPS is a disorder with multiple potential underlying causes including intercostobrachial nerve injury, intercostal neuromas, phantom breast pain, and pectoralis minor syndrome. Adding further complexity to the issue are various musculoskeletal pain syndromes including cervical radiculopathy, shoulder impingement syndrome, frozen shoulder, and myofascial pain that may occur concurrently and at times overlap with PMPS. These overlapping pain syndromes may be difficult to separate from one another, but precise diagnosis is essential, as treatment for each pain generator may be distinct. The purpose of this review is to clearly outline different pain sources based on anatomic location that commonly occur following treatment for breast cancer, and to provide tailored and evidence-based recommendations for the evaluation and treatment of each disorder. Full article
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22 pages, 4865 KiB  
Systematic Review
Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity
by Giulia Binarelli, Florence Joly, Laure Tron, Sophie Lefevre Arbogast and Marie Lange
Cancers 2021, 13(20), 5161; https://doi.org/10.3390/cancers13205161 - 14 Oct 2021
Cited by 14 | Viewed by 2400
Abstract
Cancer-related cognitive impairment (CRCI) occurs frequently in patients living with cancer, with consequences on quality of life. Recently, research on the management of these difficulties has focused on computerized cognitive stimulation and computerized physical activity programs. This systematic review presents the state of [...] Read more.
Cancer-related cognitive impairment (CRCI) occurs frequently in patients living with cancer, with consequences on quality of life. Recently, research on the management of these difficulties has focused on computerized cognitive stimulation and computerized physical activity programs. This systematic review presents the state of knowledge about interventions based on computerized-cognitive stimulation and/or physical activity to reduce CRCI. The review followed the PRISMA guidelines. A search was conducted in PUBMED and Web of Science databases. Risk of bias analysis was conducted using the Rob2 tool and the quality of evidence was conducted following the GRADE approach. A total of 3776 articles were initially identified and 20 of them met the inclusion criteria. Among them, sixteen investigated computerized-cognitive stimulation and four computerized-physical activity. Most of the studies were randomized controlled trials and assessed the efficacy of a home-based intervention on objective cognition in adults with cancer. Overall, cognitive improvement was found in 11/16 computerized-cognitive stimulation studies and 2/4 computerized-physical activity studies. Cognitive stimulation or physical activity improved especially cognitive complaints, memory, and attention. These results suggest the efficacy of both computerized-cognitive stimulation and physical activity. However, we report a high risk of bias for the majority of studies and a low level of quality of evidence. Therefore, further investigations are needed to confirm the efficacy of these interventions and to investigate the possible added benefit on cognition of a combined computerized-cognitive/physical intervention. Full article
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14 pages, 917 KiB  
Study Protocol
Multimodal Web-Based Intervention for Cancer-Related Cognitive Impairment in Breast Cancer Patients: Cog-Stim Feasibility Study Protocol
by Giulia Binarelli, Marie Lange, Mélanie Dos Santos, Jean-Michel Grellard, Anaïs Lelaidier, Laure Tron, Sophie Lefevre Arbogast, Benedicte Clarisse and Florence Joly
Cancers 2021, 13(19), 4868; https://doi.org/10.3390/cancers13194868 - 28 Sep 2021
Cited by 6 | Viewed by 2759
Abstract
Cancer-related cognitive impairment (CRCI) is a frequent side-effect of cancer treatment, with important consequences on patients’ quality of life. Cognitive stimulation and physical activity are the most efficient in improving cognitive impairment, but they are challenging to generalize in hospitals’ routine and to [...] Read more.
Cancer-related cognitive impairment (CRCI) is a frequent side-effect of cancer treatment, with important consequences on patients’ quality of life. Cognitive stimulation and physical activity are the most efficient in improving cognitive impairment, but they are challenging to generalize in hospitals’ routine and to patients’ needs and schedules. Moreover, the added value of a combination of these interventions needs to be more investigated. The Cog-Stim study is an interventional study investigating the feasibility of a web-based multimodal intervention (combining cognitive stimulation and physical activity for the improvement of cognitive complaints among breast-cancer patients currently treated with radiotherapy (n = 20). Patients will take part in a 12-week program, proposing two sessions per week of web-based cognitive stimulation (20 min/session with HappyNeuron®) and two sessions per week of web-based physical activity (30 min/session with Mooven® platform). Cognitive complaints (FACT-Cog) and objective cognitive functioning (CNS Vital Signs®), anxiety, depression (HADS), sleep disorders (ISI) and fatigue (FACIT-Fatigue) will be assessed before and after the intervention. The primary endpoint is the adherence rate to the intervention program. Patients’ satisfaction, reasons for non-attrition and non-adherence to the program will also be assessed. The overall goal of this study is to collect information to develop web-based interventions for cognitive difficulties in supportive care units. Full article
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13 pages, 300 KiB  
Article
Patient-Reported Outcomes of Regular Aerobic Exercise in Gastric Cancer
by Myung-Kyung Lee and Jihyun Oh
Cancers 2021, 13(9), 2080; https://doi.org/10.3390/cancers13092080 - 25 Apr 2021
Cited by 9 | Viewed by 2182
Abstract
The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastrointestinal disease remain unclear, and studies on gastric cancer are scant. This study examines the association between the maintenance of regular aerobic exercise at a recommended level and [...] Read more.
The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastrointestinal disease remain unclear, and studies on gastric cancer are scant. This study examines the association between the maintenance of regular aerobic exercise at a recommended level and depression and HRQOL in patients with gastric cancer during or after treatment. In this cross-sectional study, a face-to-face survey was used to collect data from 126 patients with primary gastric cancer during or after treatment in a tertiary acute-care hospital in Korea. Regular exercise was defined as regularly maintained aerobic exercise of at least moderate intensity consuming ≥4 metabolic equivalents for ≥150 min/wk for at least 6 months. Depression was measured using the 9-item version of the Patient Health Questionnaire, and HRQOL was assessed using the EORTC QLQ-C30. Patients who maintained aerobic exercise at a recommended level were less likely to have depression and more likely to have improved global QOL, as well as physical, role, and emotional functioning. Patients with depression were less likely to report improved global QOL and functioning. Thus, exercise can have a synergistic effect on improvement in HRQOL via indirect positive effects on depression and direct effects on HRQOL in patients with gastric cancer. Oncology nurses should encourage patients with gastric cancer who suffer from a depressive mood to set up and implement specific plans for practicing regular exercise, which can lead to an improvement in both depression and HRQOL. Full article
28 pages, 3877 KiB  
Systematic Review
Evidence-Based Exercise Recommendations to Improve Mental Wellbeing in Women with Breast Cancer during Active Treatment: A Systematic Review and Meta-Analysis
by Robinson Ramírez-Vélez, Fabiola Zambom-Ferraresi, Antonio García-Hermoso, Justina Kievisiene, Alona Rauckiene-Michealsson and César Agostinis-Sobrinho
Cancers 2021, 13(2), 264; https://doi.org/10.3390/cancers13020264 - 12 Jan 2021
Cited by 22 | Viewed by 6044
Abstract
Breast cancer was the most common cancer in women worldwide. The aims of the current systematic review and meta-analysis are: (i) to systematically examine the effects of exercise interventions on mental wellbeing; (ii) to examine the specific effect of the type of supervised [...] Read more.
Breast cancer was the most common cancer in women worldwide. The aims of the current systematic review and meta-analysis are: (i) to systematically examine the effects of exercise interventions on mental wellbeing; (ii) to examine the specific effect of the type of supervised exercise and its intensity, volume and frequency on mental wellbeing; and (iii) to explore which interventions are most effective in mental wellbeing among women with breast cancer during active treatment. An electronic literature search was performed using MEDLINE (via PubMed), Embase (Ovid), and Web of Science, we identified 175 full-text articles. The 57 publications included data from 6988 participants, age ranging from 18 to 78 years (weighted mean: 50.85 years). Compared with the control conditions, exercise training programs were associated with significant reductions in anxiety (d = −0.22, I2 = 53.0%), depression (d = −0.24, I2 = 66.6%), and fatigue (d = −0.47, I2 = 69.8%), as well as increases in body image (d = 0.27, I2 = 69.2%) and quality of life (overall, d = 0.46, I2 = 71.6%; emotional function, d = 0.33, I2 = 65.7%; and FACT-B, d = 0.60, I2 = 76.2%). There were a variety of frequencies, intensities, and durations of supervised exercise programs reported in the included meta-analytic approach. In addition, we found that concomitant concurrent training, at moderate-to-vigorous intensity, and with a volume ≥50 min/week had benefits on a number of health outcomes, such as fatigue, depression, and quality of life measure by the FACT-B instrument. These findings have important implications for healthcare providers and multidisciplinary teams involved in mental health management in cancer patients during active treatment. Full article
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Evaluating Oncological Rehabilitation Using Clinical Outcome Assessments: The Growing Importance of Patient-Reported Outcomes
Authors: Prof. Dr. Bernhard Holzner
Affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, The Medical University of Innsbruck, Innsbruck, Germany
Abstract: Oncological rehabilitation is aimed to help patients regain functioning and social participation. In order to justify and optimize rehabilitation, it is important to measure its outcomes in a structured way. Clinical outcome assessments (COAs) comprise different kinds of outcomes that can be used to evaluate rehabilitation. In this article we review the different types of COAs that are used in oncological rehabilitation: Clinician-Reported Outcomes (ClinROs), Observer-Reported Outcomes (ObsROs), Performance Outcomes (PerfOs), and Patient-Reported Outcomes (PROs). A special focus is placed on PROs, which are commonly defined as any direct report from the patient about their health condition without any interpretation by a third party. We review the current standing of PROs in oncological rehabilitation and trends to use PROs to benchmark value-based care. Further, we provide examples of PRO usage and highlight the benefits of electronic PRO collection, and offer advice on how to implement and integrate PROs in the oncological rehabilitation setting to maximize efficiency.

Title: Therapeutic Education and Physical Activity to Support Self-management of Cancer-related Fatigue in Hematologic Cancer Patients: Results of a Feasibility Randomized Controlled Trial
Authors: Monia Allisen Accogli; Monica Denti; Stefania Costi; Stefania Fugazzaro
Affiliation: 1 Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento n°80, 42123 Reggio Emilia, Italy; 2 Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Umberto I n°50, 42123 Reggio Emilia, Italy 3 Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Via del Pozzo n°74, 41100 Modena, Italy
Abstract: Cancer-related fatigue (CRF) is one of the most distressing symptoms reported by patients with cancer. Physical activity and therapeutic education may be beneficial for managing CRF, both during and after cancer treatment. However, there is a lack of evidence specific to hematologic malignancies. This paper describes the results of a feasibility study on Therapeutic Education and Physical Activity (TEPA) intervention to support self-management of CRF in patients with hematologic malignancies. This feasibility RCT involved a convenience sample of 40 newly diagnosed adult individuals, able to take part in a rehabilitation programme, and compared 2 parallel active interventions (Therapeutic Education versus Therapeutic Education and Physical Activity). The primary aim was to estimate the feasibility of TEPA (adherence rate to the intervention). Secondary aims were: to estimate the effect size of TEPA in terms of changes in CRF (FACIT-F), psychological distress (NCCN Distress Thermometer), QoL (EORTC QLQ-C30), physical performance (TUG, 6MWT) and habitual level of physical activity; to collect patient satisfaction, perception of usefulness and data on long-term adherence to an active lifestyle. Data were collected at the time of diagnosis and then at 1-, 3- and 7-month follow-up. Data analyses on feasibility and effect size of TEPA are ongoing. Trial registration: clinicaltrials.gov; Trial registration number: NCT03403075

Title: Importance of and Satisfaction with Domains of Health-Related Quality of Life in Cancer Rehabilitation
Authors: Andreas Hinz (correspondence), Thomas Schulte, Jochen Ernst, Anja Mehnert-Theuerkauf
Affiliation: University Medicine Leipzig
Abstract: Instruments for measuring health-related quality of life (HRQoL) generally do not consider the subjective importance of the dimensions they comprise. The aims of this study were to analyze the subjectively perceived importance of dimension of HRQoL and to investigate their relationship to the satisfaction ratings with these dimensions. A total of 1108 participants enrolled in a cancer rehabilitation program were surveyed. Patients rated eight dimensions of HRQoL (physical functioning, autonomy, emotional stability, cognitive functioning, social relationships, vitality, absence of pain, and sleep quality) as well as global health in terms of how important those dimensions are to them and how satisfied they are with them. The dimensions with the highest importance ratings were autonomy and social relationships. There were only small sex differences in the importance ratings, but younger patients rated health as being more important than older patients did. The correlations between the importance ratings and the satisfaction ratings of the specific HRQoL dimensions ranged from -0.06 to 0.40, and the correlation for global health was 0.01. Importance ratings provide relevant information for health care professionals in addition to the HRQoL assessments in the context of cancer rehabilitation.

Title: Wellbeing and Complementary Therapies in Breast Cancer Peripheral Neuropathy Care: A Scoping Review Focused on Foot Health

Authors: Raquel Veiga-Seijo; Maria Eva Perez-Lopez; Uxia Fernandez-Lopez; Abian Mosquera-Fernandez; Cristina Gonzalez-Martin

Affiliation: Universidade da Coruña, Department of Health Sciences, Faculty of Nursing and Podiatry, Campus Esteiro, 15471 Ferrol, Spain Universidade da Coruña (UDC), Research Group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, 15071 A Coruña, Spain Universidade da Coruña (UDC), Research Group in Rheumatology and Health (GIR-S), Faculty of Physiotherapy, Campus Oza, 15008 A Coruña, Spain. Medical Oncology Department, Hospital Universitario de A Coruña Instituto de Investigación Biomédica de A Coruña (INIBIC), Sergas, 15006 A Coruña, Spain
Abstract: Background. Chemotherapy-induced peripheral neuropathy is highly relevant in breast cancer because of the symptoms it triggers and the corresponding quality of life. Objectives. To map the literature on the impact of chemotherapy-induced peripheral neuropathy on the quality of life and foot health of people with breast cancer and to describe the main assessment strategies and complementary therapies. Methods. A scoping review was carried out following the PRISMA-ScR and Arksey and O'Malley guidelines. Different databases (Cochrane Plus, Scopus, Web of Science, and Pubmed) were used. 221 results were identified. 16 articles were included. Results. The thematic analysis obtained the following categories: impact of peripheral neuropathy on the development of comorbidities, foot health and its implications for the gait and quality of life, complementary therapies as a path of new strategies, and the need for clinicians and researchers to get involved in this side effect. Conclusions. Peripheral neuropathy impairs quality of life and adds comorbidity to health status. Implications for foot health and maintaining an active and healthy lifestyle have not been previously reported. Current clinical trials recommend exercise to prevent and alleviate symptoms.

Highlights: Complementary therapies are recommended by scientific evidence, but more research is needed to support their use. Advancing in this field from a comprehensive and holistic care perspective and raising awareness among healthcare professionals will make it possible to incorporate them as part of their evidence-based practice.

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