F. Mols

The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review.

Background: Providing information that is congruent with patients’ needs is an important determinant for patient satisfaction and might also affect health-related quality of life (HRQoL) and anxiety and depression levels of cancer survivors. Design: The authors systematically reviewed the available literature on the relationship between information provision and HRQoL, anxiety and depression. A PubMed literature search for original articles published until February 2010 was carried out. Twenty-five articles, all conducted between 1996 and 2009, which met the predefined inclusion criteria, were subjected to a quality checklist. Results: Satisfied patients, patients with fulfilled information needs, and patients who experience less information barriers, in general have a better HRQoL and less anxiety and depression. Out of eight intervention studies that aimed to improve information provision, only one showed a positive association with better HRQoL. Conclusion: Health care providers must pay more attention to patient-centred information provision. Additional research is needed to make definitive conclusions about information interventions as most results did not reach statistical significance due to methodological constraints. The quick development of the relatively young research field of patient-reported outcomes in cancer survivorship will make it possible to conduct better quality studies in the future.

A systematic review on chronic oxaliplatin-induced peripheral neuropathy and the relation with oxaliplatin administration.

PurposeThe aim of this study was to systematically review the literature on the influence of oxaliplatin administration (e.g. cumulative dose, dose intensity, number of cycles and combination regimen) on the long-term prevalence of oxaliplatin-induced peripheral neuropathy (O-IPN) at least 12xa0months after termination of chemotherapy.MethodsA computerized search of literature on databases PubMed and Cochrane was performed. Published original articles were included if they reported about long-term O-IPN and gave concomitant information about oxaliplatin therapy given to the patients. All articles were assessed for quality.ResultsWe included 14 articles (nu2009=u20093,869 patients), and the majority of these studies were of high quality. All included patients who were treated for colorectal cancer, mainly with oxaliplatin in combination with 5-fluorouracil/leucovorin. Median cumulative doses and dose intensity varied between 676 and 1,449xa0mg/m2 and 30.8 and 42.6xa0mg/m2/week, respectively. Neuropathy assessment differed between studies, and the National Cancer Institute-Common Terminology Criteria (NCI-CTC) was used most often. The degree of neuropathy ranged from grade 0 to 3. Only six studies directly assessed the relationship between oxaliplatin administration and neuropathy. Of these studies, five did find a relation between neuropathy and higher cumulative dose, while one study did not find a relation.ConclusionsO-IPN is still present in a great amount of patients in ≥12xa0months after termination of therapy. A higher cumulative dose is likely to have an influence on the development of long-term O-IPN. More studies are needed that assess long-term neuropathy and oxaliplatin administration by means of validated neuropathy assessments.

Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors: A study from the population-based PROFILES registry

Abstract Background. Given the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQoL) during the follow-up period is of considerable concern. Therefore, the first aim of this study was to assess (thyroid cancer specific) HRQoL among long-term thyroid cancer survivors and to compare this with the HRQoL of an age- and sex-matched normative population. Secondly, our aim was to investigate which clinical and socio-demographic characteristics and thyroid cancer specific problems were associated with HRQoL. Material and methods. All patients diagnosed with thyroid cancer between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a survey on HRQoL (EORTC QLQ-C30) and disease-specific symptoms (THYCA-QoL). The scores were compared with age- and sex-matched cancer free controls (n = 800). A series of multiple linear regression analyses were conducted to investigate the independent associations between clinical, socio-demographic and thyroid cancer specific factors with HRQoL. Results. A total of 306 patients (86%) responded to the invitation. Thyroid cancer survivors had significantly lower scores on physical, role, emotional, cognitive and social functioning (p < 0.001) compared to the normative population after adjusting for comorbidities. Sympathetic problems [feeling chilly (52%), hot flushes (40%)], neuromuscular problems [cramp legs (43%) and pain joints/muscles (64%)] and abrupt attacks of fatigue (50%) were the most often reported thyroid cancer specific complaints. Thyroid cancer specific neuromuscular, concentration, sympathetic and psychological problems explained 41–58% of the variance in HRQoL. Clinical and socio-demographic factors explained a small part of the variance in (thyroid cancer specific) HRQoL (1–27%). Conclusion. Long-term thyroid cancer survivors experience more symptoms and deteriorated HRQoL compared to the normative population. Thyroid cancer specific neuromuscular, sympathetic, concentration and psychological symptoms are stronger associated with HRQoL than clinical and socio-demographic factors alone. Awareness of these specific determinants of HRQoL could help health care practitioners to provide better supportive care.

Assessing the impact of chemotherapy-induced peripheral neurotoxicity on the quality of life of cancer patients: the introduction of a new measure.

PurposeTo investigate the impact of chemotherapy-induced neurotoxicity on daily activities and quality of life (QoL) of cancer patients.MethodsQoL of all patients visiting the oncological outpatient ward of the Maxima Medical Centre in the Netherlands from October 2006 until March 2007 treated with taxanes, vinca-alkaloids and/or platinum compounds (nu2009=u200988) was compared with the QoL of patients that did not receive these treatments yet (nu2009=u200943). Patient-reported neuropathy symptoms were evaluated with the newly developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group/Neurotoxicity (FACT/GOG-Ntx) questionnaire.ResultsPatients treated with chemotherapy reported significantly more complaints of neuropathy (pu2009<u20090.001) and more paresthesias and dysesthesias in the upper (pu2009<u20090.001; pu2009<u20090.01) and lower extremities (pu2009<u20090.001) compared to those not treated with chemotherapy. They additionally experienced problems with fine motor function (e.g., getting (un)dressed, writing, and picking up small objects). Moreover, cold-induced paresthesias were frequently reported. Overall, patients indicated that their neuropathy had a negative effect on QoL.ConclusionsThe newly developed CINQ and the FACT/GOG-Ntx results suggest a considerable negative impact of patient-reported neuropathy symptoms on daily activities and QoL in cancer patients treated with chemotherapy. However, further validation of the CINQ is needed.

Increased health care utilisation among 10-year breast cancer survivors

ObjectiveWe investigated self-reported health care utilisation of women who survived breast cancer for 10xa0years and identified predictors of health care utilisation.MethodsThe population-based Eindhoven Cancer Registry was used to select all women who were diagnosed with breast cancer in 1993, in six hospitals in the Netherlands, and were disease-free at the time of data collection. Health status, psychological well-being, satisfaction with life and health care use were compared with same age controls. Logistic regression was used to identify predictors of health care utilisation.ResultsOf the 254 women who were sent a questionnaire, 183 (72%) responded. Breast cancer survivors had a similar health status and psychological well-being and a better satisfaction with life compared to same age controls. The proportion of breast cancer survivors (79%) who visited a specialist in the past 12xa0months was significantly higher compared to controls (53%). Young breast cancer survivors (45–54 at time of completing questionnaire) more often visited a physical therapist (56%) or complementary caregiver (26%) than controls (29 and 13%, respectively). Spontaneously reported problems (fatigue, arm problems) as a consequence of cancer and co-morbidity showed the strongest associations with health care utilisation.ConclusionsAlthough self-reported health, satisfaction with life and psychological well-being were similar or even better in long-term breast cancer survivors compared to those in population controls, survivors more often attended a specialist, physical therapist and complementary caregiver in the past 12xa0months. Survivors of young age appear to have the highest use of health care services compared to age-matched controls, especially related to fatigue and arm problems.

Unmet information needs and impact of cancer in (long‐term) thyroid cancer survivors: results of the PROFILES registry

The objective of this study was to provide insight into the following: (a) the perceived level of, satisfaction with, and helpfulness of received information and unmet information needs among thyroid cancer (TC) survivors and (b) the relation between unmet information needs and impact of cancer (IOC).

Quality of life more impaired in younger than in older diffuse large B cell lymphoma survivors compared to a normative population: a study from the population-based PROFILES registry

The objective of this study was to compare health-related quality of life (HRQOL) between diffuse large B cell lymphoma (DLBCL) survivors of different age categories (18–59/60–75/76–85xa0years) and to compare their HRQOL with an age- and sex-matched normative population. The population-based Eindhoven Cancer Registry was used to select all patients diagnosed with DLBCL from 1999 to 2010. Patients (nu2009=u2009363) were invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire, and 307 survivors responded (85xa0%). Data from an age- and sex-matched normative population (nu2009=u2009596) were used for comparison. DLBCL survivors aged 18–59xa0years scored better on physical functioning, quality of life, appetite loss and constipation than survivors of 76–85xa0years old (all pu2009<u20090.05). Financial problems more often occurred in survivors aged 18–59xa0years compared to survivors of 76–85xa0years old (pu2009<u20090.01). Compared to the normative population, DLBCL survivors aged 18–59xa0years showed worse scores on cognitive and social functioning and on dyspnea and financial problems (pu2009<u20090.01, large- and medium-size effects). In survivors of the other age categories, only differences with trivial or small-size effects were found. Although younger DLBCL survivors have better HRQOL than older survivors, the differences found between younger survivors and normative population were the largest. This suggests that having DLBCL has a greater impact on younger than older survivors and that the worse HRQOL observed in older DLBCL survivors in comparison with younger survivors is caused mostly by age itself and not by the disease.

Low subjective health literacy is associated with adverse health behaviors and worse health-related quality of life among colorectal cancer survivors : Results from the profiles registry

The objectives of the study were to examine the prevalence of health literacy (HL) among colorectal cancer (CRC) survivors and the relation between HL and health behaviors and to explore whether or not HL and health behaviors are independently associated with health‐related quality of life (HRQoL) and mental distress.

Symptoms of Anxiety and Depression Are Associated With Satisfaction With Information Provision and Internet Use Among 3080 Cancer Survivors: Results of the PROFILES Registry

Background: Dissatisfaction with information provided by healthcare providers may be a reason for cancer survivors to seek health information on the Internet and may also result in more symptoms of anxiety and depression among this population. Objective: The aim of this study was to investigate whether anxious and depressive symptoms are associated with satisfaction with information provision and Internet use among cancer survivors. Methods: All individuals diagnosed with endometrial or colorectal cancer between 1998 and 2007 or lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry were invited for participation. In total, 4 446 survivors received a questionnaire including the 25-item European Organisation for Research and Treatment of Cancer Quality of Life Group Information questionnaire and Hospital Anxiety and Depression Scale; 69% responded (n = 3080). Results: Having anxious (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.5–0.9; P < .05) or depressive symptoms (OR, 0.5; 95% CI, 0.4–0.7; P < .001), or both (OR, 0.4; 95% CI, 0.4–0.7; P < .001) were negatively associated with experienced helpfulness of the received information. Having depressive symptoms or having both depressive and anxious symptoms were negatively associated with satisfaction with information (OR, 0.5; 95% CI, 0.4–0.7; OR, 0.5; 95% CI, 0.4–0.7, respectively; P < .001). Having depressive symptoms was negatively associated with disease-related Internet use (OR, 0.69; 95% CI, 0.5–0.9; P < .05). Conclusion: The results may indicate that information provision is suboptimal, either because it is not adjusted to the mental health status of cancer patients or because it is unsatisfactory and thereby causing anxious and depressive symptoms among cancer patients. Implications for Practice: More attention should be paid to optimally adjust the information provision to the individual needs of the cancer patients for better mental health.

Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice

PurposeChemotherapy-induced peripheral neuropathy (CIPN) may negatively influence multiple myeloma (MM) patients’ health-related quality of life (HRQOL). Dose modification is the only way to minimize CIPN. To measure CIPN in daily practice, the Indication for Common Toxicity Criteria (CTC) Grading of Peripheral Neuropathy Questionnaire (ICPNQ) was developed which can be completed within five minutes by the patient. The aims of this study were to (1) perform a psychometric evaluation of the ICPNQ and (2) examine the prevalence of CIPN and its influence on HRQOL in population-based MM patients.MethodsOne hundred fifty-six MM patients, diagnosed between 2000 and 2014, completed the ICPNQ, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy 20 (EORTC QLQ-CIPN20), and EORTC QLQ-C30 (65xa0% response).ResultsThe psychometric analyses showed a Cronbach’s alpha of 0.84, 0.74, and 0.61 for, respectively, the sensory, motoric, and autonomic subscales of the ICPNQ. Test-retest reliability and construct validity were good for all subscales. Overall, 65xa0% of patients reported grade 2–3 neuropathy according to the ICPNQ. Patients with the highest CTC grades (grade 2 with neuropathic pain and grade 3 (38xa0%)) according to the ICPNQ reported significantly worse scores on all EORTC QLQ-CIPN20 subscales compared to patients with lower CTC grades (pxa0≤xa00.002). In addition, they reported statistically significant and clinically relevant worse HRQOL scores on almost all EORTC QLQ-C30 subscales.ConclusionsCIPN is a common side effect in MM patients, which has a negative impact on HRQOL. The ICPNQ is a valid instrument to distinguish the highest CIPN CTC grades from the lower CTC grades necessary to decide on dose modifications of chemotherapy in daily clinical practice.