Floortje Mols

Chemotherapy-Induced Neuropathy and Its Association With Quality of Life Among 2- to 11-Year Colorectal Cancer Survivors: Results From the Population-Based PROFILES Registry

PURPOSE To gain insight into the prevalence and severity of chemotherapy-induced neuropathy and its influence on health-related quality of life (HRQOL) in a population-based sample of colorectal cancer (CRC) survivors 2 to 11 years after diagnosis. METHODS All alive individuals diagnosed with CRC between 2000 and 2009 as registered by the Dutch population-based Eindhoven Cancer Registry were eligible for participation. Eighty-three percent (n = 1,643) of patients filled out the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and the EORTC QLQ Chemotherapy-Induced Peripheral Neuropathy 20. RESULTS The five neuropathy subscale-related symptoms that bothered patients with CRC the most during the past week were erectile problems (42% of men), trouble hearing (11%), trouble opening jars or bottles (11%), tingling toes/feet (10%), and trouble walking stairs or standing up (9%). Additionally, patients who received oxaliplatin more often reported tingling (29% v 8%; P = .001), numbness (17% v 5%; P = .005), and aching or burning pain (13% v 6%; P = .03) in toes/feet compared with those not treated with chemotherapy. They also more often reported tingling toes/feet (29% v 14%; P = .0127) compared with those treated with chemotherapy without oxaliplatin. Those with many neuropathy symptoms (eg, upper 10%) reported statistically significant and clinically relevant worse HRQOL scores on all EORTC QLQ-C30 subscales (all P < .01). CONCLUSION Two to 11 years after diagnosis of CRC, neuropathy-related symptoms are still reported, especially sensory symptoms in the lower extremities among those treated with oxaliplatin. Because neuropathy symptoms have a negative influence on HRQOL, these should be screened for and alleviated. Future studies should focus on prevention and relief of chemotherapy-induced neuropathy.

Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors.

This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patients life do not occur in all cancer patients and all phases of the disease trajectory.

Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems

BackgroundThe objective was to review all available literature concerning Type D (distressed) personality among the general population and to discuss its implications for research on health status, disease-promoting mechanisms and work-related problems in non-clinical populations.MethodsA computerized search of the literature was performed independently and in duplicate by both investigators on December 21st, 2009. Published research reports were included if they studied Type D personality among the general population. Nineteen articles were selected and they were subjected to an 11-item standardised quality checklist by both investigators.ResultsThe methodological quality of the selected studies was adequate to high. The studies included in this review showed that the presence of Type D characteristics had a negative impact on mental health status (more symptoms of depression, anxiety, post-traumatic stress disorder, mental distress, passive coping, and less social support) and physical health status (more somatic complaints, lower health status, more influenza-like illness reporting). Other studies reported on behavioral and biological mechanisms of disease in apparently healthy individuals with a Type D personality. Finally, some studies also showed a negative effect of Type D personality on work-related problems (higher absence-leave, higher levels of vital exhaustion and burnout, and more work-related stress).ConclusionsType D personality is a vulnerability factor for general psychological distress that affects mental and physical health status and is associated with disease-promoting mechanisms and work-related problems in apparently healthy individuals.

Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

PURPOSE In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. METHODS AND MATERIALS All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 were identified through the cancer registry. Generic HRQoL (36-Item Short-Form Health Survey, EQ-5D), cervical cancer-specific HRQoL (European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module), and anxiety (6-item State Trait Anxiety Inventory) were assessed and compared with a reference population (n = 349). Data for tumor characteristics at diagnosis and disease progression were available. RESULTS A total of 291 women responded (69%), with a mean age of 53 +/- 13 (SD) years (range, 31-88 years). Treatment had consisted of surgery (n = 195) or a combination of therapies (n = 75); one woman had not been treated. Of all women, 85% were clinically disease free, 2% had a recurrence/metastasis, and in 13%, this was unknown. After controlling for background characteristics (age, education, job and marital status, having children, and country of birth), generic HRQoL scale scores were similar to the reference population, except for worse mental health in survivors. The most frequent symptoms were crampy pain in the abdomen or belly (17%), urinary leakage (15%), menopausal symptoms (18%), and problems with sexual activity. Compared with the 6-10-year survivors, more sexual worry and worse body image were reported by the 2-5-year survivors. Compared with surgery only, especially primary radiotherapy was associated with an increased frequency of treatment-related side effects, also after controlling for age and disease stage at diagnosis and follow-up. CONCLUSIONS Most cervical cancer survivors were coping well, although their mental health was worse than in the reference population. Even after 2-10 years, radiotherapy was associated with an increased frequency of treatment-related side effects.

Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review

BackgroundThe objective of this study was to systematically review all available literature concerning chemotherapy-induced peripheral neuropathy (CIPN) and quality of life (QOL) among cancer patients.MethodsA computerized search of the literature was performed in December 2013. Articles were included if they investigated CIPN and QOL among cancer patients. Twenty-five articles were selected and were subjected to a 13-item quality checklist independently by two investigators.ResultsThe methodological quality of the majority of the selected studies was adequate to high. The included studies differed tremendously with respect to study design (19 prospective studies, 5 cross-sectional, 1 both cross-sectional and prospective), patient population (lung, colorectal, ovarian, endometrial, cervical or breast cancer, lymphoma, acute lymphoblastic leukemia, or a mixed population), number of included patients (ranging from 14 to 1643), and ways to assess CIPN (objectively, subjectively, or both). Of the 25 included studies, 11 assessed the association of CIPN on patients’ QOL. While three of these studies did not find an association between CIPN and QOL, the others concluded that more CIPN was associated with a lower QOL.Implications for cancer survivorsAlthough the included studies in this systematic review were very diverse, which impedes drawing firm conclusions on this topic, CIPN is likely to have a negative association with QOL. The variety of the studied patient populations and chemotherapeutic agents in the existing studies calls for further studies on this topic. These studies are preferably prospective in nature, include a large number of patients, and assess QOL and CIPN with validated questionnaires.

Type D personality among noncardiovascular patient populations: a systematic review.

OBJECTIVE This article reviews all available literature concerning the implications of Type D personality (the conjoint effects of negative affectivity and social inhibition) among patients with noncardiovascular conditions. METHODS Published papers were included if they studied Type D personality among noncardiovascular patient populations. Twelve articles met our inclusion criteria and were subjected to a methodological quality checklist (e.g., sample size, response rate, Type D measurement). RESULTS The methodological quality of the selected studies was quite good. The noncardiovascular patient populations included chronic pain, asthma, tinnitus, sleep apnea, primary care patients, vulvovaginal candidiasis, mild traumatic brain injury, vertigo, melanoma and diabetic foot syndrome. Type D personality was associated with an increased number or severity of reported health complaints, heightened the perception of negative emotions (e.g., depression and anxiety), had an adverse effect on health-related behaviors, was associated with poor adherence to treatment and significantly reduced effort to perform during diagnostic testing. CONCLUSION Type D is a vulnerability factor that not only affects people with cardiovascular conditions but also those with other medical conditions. Type D was associated with poor physical and mental health status and poor self-management of the disease. Consequently, including Type D in future studies seems warranted.

Illness perceptions in cancer survivors: what is the role of information provision?

The aim of this study was to provide insight into the relationship between information provision and illness perceptions among cancer survivors.

Quality of life among long-term non-Hodgkin lymphoma survivors : A population-based study

The objective of this population‐based study was to document the long‐term effects (5–15 years postdiagnosis) of non‐Hodgkin lymphoma and its treatment on health‐related quality of life (HRQL) and social problems.

Long-term cancer survivors experience work changes after diagnosis: Results of a population-based study.

Background: Although cancer survivorship is increasing with improved diagnosis and treatments, few studies have explored employment changes and the factors related to this change among cancer survivors. Therefore, we aim to explore the prevalence of employment problems in long‐term cancer survivors. In addition, we explored what patient or tumour characteristics predicted employment changes.

Long-term quality of life among Dutch prostate cancer survivors: Results of a population-based study

In this report, the authors describe the health‐related quality of life (HRQL) of long‐term prostate cancer survivors 5 to 10 years after diagnosis and compare it with the HRQL of an age‐matched, normative sample of the general Dutch population.