scholarly journals Psychosocial stress and ovarian function in adolescent and young adult cancer survivors

2020 ◽  
Author(s):  
Jayeon Kim ◽  
Brian W Whitcomb ◽  
Brian Kwan ◽  
David Zava ◽  
Patrick M Sluss ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Perceived Stress ◽  
Cancer Diagnosis ◽  
Psychosocial Stress ◽  
Ovarian Function ◽  
Severe Stress ◽  
Cross Sectional ◽  
Phase Cycle ◽  
Adult Cancer Survivors ◽  
Menstrual Pattern

Abstract STUDY QUESTION Is psychosocial stress associated with ovarian function in reproductive-aged survivors of cancer diagnosed as adolescents and young adults (AYA survivors)? SUMMARY ANSWER We observed no association between self-reported and biomarkers of psychosocial stress and ovarian function in AYA survivors. WHAT IS KNOWN ALREADY Psychosocial stress suppresses hypothalamic-pituitary-ovarian axis, resulting in ovulatory dysfunction, decreased sex steroidogenesis and lower fertility in reproductive-aged women. Many cancer survivors experience high psychosocial stress and hypothalamic-pituitary-adrenal axis dysregulation. The menstrual pattern disturbances and infertility they experience have been attributed to ovarian follicle destruction, but the contribution of psychosocial stress to these phenotypes is unknown. STUDY DESIGN, SIZE, DURATION A cross-sectional study was conducted estimating the association between perceived stress, measured by self-report and saliva cortisol, and ovarian function, measured by bleeding pattern, dried blood spot (DBS) FSH and LH, and saliva estradiol. We included 377 AYA survivor participants. PARTICIPANTS/MATERIALS, SETTING, METHODS AYA survivor participants were ages 15–35 at cancer diagnosis and ages 18–40 at study enrollment, had completed primary cancer treatment, had a uterus and at least one ovary, did not have uncontrolled endocrinopathy and were not on hormone therapy. Recruited from cancer registries, physician referrals and cancer advocacy groups, participants provided self-reported information on psychosocial stress (Perceived Stress Scale-10 (PSS-10)) and on cancer and reproductive (fertility, contraception, menstrual pattern) characteristics. DBS samples were collected timed to the early follicular phase (cycle Days 3–7) for menstruating individuals and on a random day for amenorrheic individuals; saliva samples were collected three time points within 1 day. FSH and LH were measured by DBS ELISAs, cortisol was measured by ELISA and estradiol was measured by liquid chromatography tandem mass spectrometry. MAIN RESULTS AND THE ROLE OF CHANCE The median age of participants was 34.0 years (range 19–41) at a median of 6.0 years since cancer diagnosis. The most common cancer was breast (32.1%). Median PSS-10 score was 15 (range 0–36), with 5.3% scoring ≥26, the cut point suggestive of severe stress. Cortisol levels followed a diurnal pattern and cortisol AUC was negatively correlated with PSS-10 scores (P = 0.03). Neither PSS-10 scores nor cortisol AUC were associated with FSH, LH, estradiol levels or menstrual pattern. Waking and evening cortisol and the cortisol awakening response also were not related to ovarian function measures. LIMITATIONS, REASONS FOR CAUTION Our analysis is limited by its cross-sectional nature, heterogeneity of cancer diagnosis and treatments and low prevalence of severe stress. WIDER IMPLICATIONS OF THE FINDINGS The lack of association between psychosocial stress and a variety of ovarian function measures in female AYA cancer survivors suggests that psychosocial stress does not have a significant impact on the reproductive axis of AYA survivors. This finding is important in counseling this population on their menstrual pattern and family building plans. STUDY FUNDING/COMPETING INTEREST(S) NIH HD080952, South Korea Health Industry Development Institute HI18C1837 (JK). Dr A.D. works for Bluebird Bio, Inc., Dr D.Z. works for ZRT Labs and Dr P.M.S. works for Ansh Labs, which did not sponsor, support or have oversight of this research. Other authors report no competing interests. TRIAL REGISTRATION NUMBER N/A

scholarly journals Impact of gender and employment type on job loss among cancer survivors

2020 ◽  
Vol 50 (7) ◽  
pp. 766-771
Author(s):  
Miyako Tsuchiya ◽  
Yoshitsugu Horio ◽  
Hatsumi Funazaki ◽  
Kenjiro Aogi ◽  
Kazue Miyauchi ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Job Loss ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Temporary Employees ◽  
Adult Cancer Survivors ◽  
After Cancer ◽  
Response Rate Data ◽  
Balance Treatment

Abstract Objective To identify factors associated with cancer-related job loss following cancer diagnosis. Methods A multicentre cross-sectional survey was conducted among adult cancer survivors employed at the time of cancer diagnosis. Hierarchical multivariate logistic regression was used to examine the association of gender and employment type with job loss after cancer diagnosis and if the interaction between gender and employment type predicted job loss. Results Of 1618 patients recruited, 1483 returned questionnaires (91.7% response rate). Data from 708 patients were eligible for analyses. Approximately 21% of patients had lost their job within 10 years of diagnosis. Patients who had undergone chemotherapy were more likely to lose their jobs than those who had not (OR = 3.24, 95% CI 2.13–4.91). Women were more likely to lose their jobs than men (OR = 2.58, 95% CI 1.48–4.50). Temporary employees were more likely to lose their jobs than regular employees (OR = 2.62, 95% CI 1.72–3.99). After controlling for demographic and clinical characteristics, no interaction effects between gender and employment type were observed (P = 0.44). Conclusions Women and temporary employees are more vulnerable to cancer-related job loss. Clinicians need greater awareness of the risk of patient job loss, and they need to assess patients’ employment types and provide appropriate support to balance treatment schedules and work.

scholarly journals Survivors’ Dilemma: Young Adult Cancer Survivors’ Perspectives of Work-Related Goals

2021 ◽  
pp. 216507992110126
Author(s):  
Lauren Victoria Ghazal ◽  
John Merriman ◽  
Sheila Judge Santacroce ◽  
Victoria Vaughan Dickson
Keyword(s):  
Content Analysis ◽  
Young Adult ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Financial Toxicity ◽  
Self Identity ◽  
Work Related ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

Background: Young adult cancer survivors have significant work-related challenges, including interruptions to education and employment milestones, which may affect work-related goals (WRGs). The study purpose was to explore posttreatment perspectives of WRGs in a sample of young adult hematologic cancer survivors. Methods: This qualitative descriptive study used social media to recruit eligible cancer survivors (young adults working or in school at the time of cancer diagnosis). Data were collected through telephone semi-structured interviews and analyzed using directed content analysis, followed by thematic content analysis to identify themes. Findings: The sample ( N = 40) were mostly female (63.5%), White (75%), and diagnosed with Hodgkin lymphoma (57.5%); most worked in professional (40%) or health care (23%) roles. The overarching theme, “Survivors’ Dilemma,” highlights a changed perspective on work-related fulfillment and financial obligations, capturing survivors’ decision-making process regarding work. Three subthemes illustrated questions that participants contemplated as they examined how their WRGs had changed: (a) Self-identity: Do I want to do this work? (b) Perceived health and work ability: Can I do this work? and (c) Financial toxicity: Can I afford to/not to do this work? Conclusions/Application to Practice: Participants experienced a state of dilemma around their WRGs, weighing areas around self-identity, perceived health and work ability, and financial toxicity. Findings suggest occupational health nurses should be aware of challenges surrounding WRGs, including how goals may change following a cancer diagnosis and treatment, and the potential stressors involved in the Survivors’ Dilemma. Occupational health nurses should assess for these issues and refer young survivors to employee and financial assistance programs, as necessary.

scholarly journals Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3368
Author(s):  
Dafina Petrova ◽  
Andrés Catena ◽  
Miguel Rodríguez-Barranco ◽  
Daniel Redondo-Sánchez ◽  
Eloísa Bayo-Lozano ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Depression Symptoms ◽  
Depression Risk ◽  
Adult Cancer Survivors ◽  
Before And After ◽  
Nationally Representative ◽  
Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

scholarly journals The Role of Physical Activity in Cancer Survivors’ Quality of Life

2020 ◽  
Author(s):  
Tayah M. Liska ◽  
Angie Kolen
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Social Engagement ◽  
Healthcare Providers ◽  
Adult Cancer Survivors

Abstract Purpose: As a result of a cancer diagnosis and treatment, many cancer survivors experience persistent physical, mental, and emotional symptoms that affect their quality of life. Physical activity has been identified as an intervention that may help to manage the side effects of a cancer diagnosis and its treatment. The purpose of this study was to investigate the role of physical activity on overall quality of life in adult cancer survivors. Methods: One-on-one semi structured interviews were conducted in person or via telephone with 13 adult (≥18 yrs) cancer survivors who had completed cancer treatment. Results: These cancer survivors described their physical activity as improving their physical functioning and mental health, as a means of positive social engagement, and adding positivity to their daily life. Conclusion: These results support the role of physical activity to enhance cancer survivors’ quality of life regardless of the individuals’ treatment(s) type, duration, or time since the end of active cancer treatment. Further research is warranted to (a) expand this research with a larger sample, (b) examine healthcare providers’ knowledge and application of exercise guidelines to cancer survivors in cancer care, and (c) explore implementation strategies for greater advocacy for healthcare providers to share the exercise recommendations with cancer survivors.

Expression of the senescence biomarker p16INK4a among childhood, adolescent, and young adult cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 10556-10556
Author(s):  
Andrew Brian Smitherman ◽  
Vanessa L Ayer Miller ◽  
Natalia Mitin ◽  
Allison Mary Deal ◽  
Hyman B. Muss
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Cellular Senescence ◽  
Adolescent And Young Adult ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

10556 Background: The mechanism of accelerated aging among survivors of childhood, adolescent, and young adult cancer is not clearly understood. Cellular senescence may contribute to this process. We measured peripheral blood T lymphocyte p16INK4a expression, a biomarker of cellular senescence and aging, among pediatric and young adult cancer survivors hypothesizing that p16INK4a expression is higher due to chemotherapy exposure and among frail survivors. Methods: Two cohorts were enrolled from January 2018 to December 2019 at an academic medical center. One, a cross-sectional cohort of young adult cancer survivors and age-matched, cancer-free controls in whom we assessed p16INK4a expression and clinical frailty. Frailty was measured with the modified Fried Frailty Index that evaluates skeletal muscle index, weakness, slowness, leisure energy expenditure, and exhaustion. A second cohort underwent prospective measurement of p16INK4a expression before and after cancer chemotherapy. Eligibility among survivors and newly diagnosed patients required treatment with an alkylating agent, an anthracycline / anthracenedione, or both. Multivariable linear regression was used to model expression of p16INK4a by patient age at assessment, treatment intensity, and frailty status. Results: The cross-sectional cohort enrolled 60 young adult survivors and 29 age-matched, cancer-free controls with median age 21 years and range 17-29 years for both groups. Survivors were a median of 5.5 years from end of treatment. The prospective cohort enrolled nine newly diagnosed patients (range 1-18 years). Expression of p16INK4a was higher among young adult cancer survivors as compared to age-matched controls (9.6 v. 8.9 log2 p16 units, p < 0.01) representing a 25-year age acceleration in the survivors. Expression of p16INK4a increased among newly diagnosed patients from matched pre- to post-treatment samples (7.3 to 8.9 log2 p16 units, p = 0.002). Nine survivors (16%) met criteria for being frail and had higher p16INK4a expression as compared to robust survivors (10.5 [frail] v. 9.5 [robust] log2 p16 units, p = 0.055). Conclusions: Chemotherapy is associated with increased cellular senescence in pediatric and young adult cancer survivors as reflected in expression of p16INK4a indicating an increase in molecular age following chemotherapy exposure. The large proportion of frail survivors in this study also exhibited higher levels of p16INK4a suggesting that cellular senescence may be associated with early aging observed among these survivors.

scholarly journals Cancer Information Satisfaction among Indonesian Cancer Survivors

2021 ◽  
pp. 1
Author(s):  
Wenny Savitri ◽  
Masta Hutasoit
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Cross Sectional Study ◽  
Cancer Information ◽  
Cross Sectional ◽  
Adult Cancer Survivors ◽  
Health Related ◽  
The Impact

Information for cancer patients is significant to overcome a cancer diagnosis and its treatment, affecting patients' quality of life. This study aimed to assess the level of satisfaction with the information on illness treatment among Indonesian cancer survivors, explore its association with the patients' demographic and health-related characteristics, and provide recommendations and improve the information. Sixty adult cancer survivors at the oncology unit of Panembahan Senopati Bantul Hospital of Yogyakarta, Indonesia, were recruited in a cross-sectional study design completing a demographic and health-related data form and the Satisfaction with Cancer Information Profile Questionnaire. The data were then analyzed using descriptive statistics and path analysis. Most patients were dissatisfied with the amount and content of cancer information provided by health care ranging from 12-67%, particularly on the information regarding managing unwanted-side effects of the treatment and the impact of their cancer treatment on long-term quality of life. The patients were also discontented with the detail of information, the timing,  and the usefulness of information to others. Demographic and health-related characteristics directly influence the patients' satisfaction of information (β= 0.461, p = 0.045). Patients who were divorced, not living with their spouses, and diagnosed with cancer for a longer time (more than two years) were the significant contributors to directly influencing their satisfaction. Nurses need to enhance the detail of information, find the best time to provide and design a better way to deliver cancer patients' information.

scholarly journals The Person I Used To Be: Employment Experiences of Young Adults with Cancer

2020 ◽  
Author(s):  
Melissa C. Scardaville ◽  
Kathleen M. Murphy ◽  
Marla Clayman ◽  
Rhonda Robert ◽  
Sandra Medina-George ◽  
...  
Keyword(s):  
Young Adults ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Structured Interviews ◽  
Career Trajectory ◽  
Short Term ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
The Impact

Abstract Purpose: Adults can experience employment-related hardships after a cancer diagnosis but young adults at the beginning of their careers may face unique challenges. This study explored the impact of cancer on young adults’ employment experiences. Methods: The authors conducted 27 qualitative semi-structured interviews with young adults who had received a cancer diagnosis. Results: Participants encountered mixed workplace support. Many reported that they did not have the benefits, such as time off or short-term disability insurance, that would have ameliorated some challenges encountered during treatment. They also shared that many workplaces do not do an adequate job of informing people with cancer about federal laws that protect people with disabilities. Most participants reported that the cancer diagnosis and treatment caused them to rethink their career trajectory.Conclusions: Cancer affects young adults in ways that present distinct struggles attributable to less access to resources. Career choices and the consequent opportunities for on-the-job training can have lifelong import.Implications for Cancer Survivors: Disability and discrimination laws do not protect all employees. Young adult cancer survivors may need to conduct their own research into these protections so they can receive entitled benefits. They and employers may also benefit from workplace interventions or trainings to lessen the employment consequences of cancer.

scholarly journals Prevalence of Self-Reported Memory Problems in Adult Cancer Survivors: A National Cross-Sectional Study

2012 ◽  
Vol 8 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Pascal Jean-Pierre ◽  
Paul C. Winters ◽  
Tim A. Ahles ◽  
Michael Antoni ◽  
F. Daniel Armstrong ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cognitive Dysfunction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Memory Problems ◽  
Adult Cancer Survivors ◽  
Racial Ethnic

Cancer-related cognitive dysfunction remains after controlling for variables such as socioeconomic and racial/ethnic status; it should be more systematically assessed and treated among patients and survivors.

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