Jeff Dunn

The supportive care needs of men with prostate cancer (2000)

The diagnosis and subsequent treatment of prostate cancer is followed by a range of significant disease specific and iatrogenic sequelae. However, the supportive care needs of men with prostate cancer are not well described in the literature. The present study assesses the supportive care needs of men with prostate cancer who are members of prostate cancer self‐help groups in Queensland, Australia. In all, 206 men aged between 48 and 85 years (mean=68) completed the Supportive Care Needs Survey (SCNS) (62% response). The SCNS is a validated measure assessing perceived need in the domains of psychological needs, health system and information needs, physical and daily living needs, patient care and support, and sexuality. Items assessing need for access to services and resources were also included.

Predictors of change in unmet supportive care needs in cancer

Objective: Patient Reported Outcome (PRO) assessments can assist health professionals to tailor their health practices to the individual needs of patients and improve patient care over time. The present study assessed prospective predictors of unmet supportive care needs in cancer patients over a six‐month period.

A systematic review of the impact of stigma and nihilism on lung cancer outcomes

BackgroundThis study systematically reviewed the evidence on the influence of stigma and nihilism on lung cancer patterns of care; patients’ psychosocial and quality of life (QOL) outcomes; and how this may link to public health programs.MethodsMedline, EMBASE, ProQuest, CINAHL, PsycINFO databases were searched. Inclusion criteria were: included lung cancer patients and/or partners or caregivers and/or health professionals (either at least 80% of participants had lung cancer or were partners or caregivers of lung cancer patients, or there was a lung cancer specific sub-group focus or analysis), assessed stigma or nihilism with respect to lung cancer and published in English between 1st January 1999 and 31st January 2011. Trial quality and levels of evidence were assessed.ResultsEighteen articles describing 15 studies met inclusion criteria. The seven qualitative studies were high quality with regard to data collection, analysis and reporting; however most lacked a clear theoretical framework; did not address interviewer bias; or provide a rationale for sample size. The eight quantitative studies were generally of low quality with highly selected samples, non-comparable groups and low participation rates and employed divergent theoretical and measurement approaches. Stigma about lung cancer was reported by patients and health professionals and was related to poorer QOL and higher psychological distress in patients. Clear empirical explorations of nihilism were not evident. There is qualitative evidence that from the patients’ perspectives public health programs contribute to stigma about lung cancer and this was supported by published commentary.ConclusionsHealth-related stigma presents as a part of the lung cancer experience however there are clear limitations in the research to date. Future longitudinal and multi-level research is needed and this should be more clearly linked to relevant theory.

The IPOS new International Standard of Quality Cancer Care: integrating the psychosocial domain into routine care.

Jimmie Holland, Maggie Watson and Jeff Dunn Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA Psychology Research Group, Sycamore House, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK Griffith Health Institute, Griffith University, Australia School of Social Science, University of Queensland, Australia Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Australia

Describing and predicting psychological distress after colorectal cancer

Psychological distress in cancer survivors can be detrimental to treatment adherence and self‐care tasks and is associated with poor health behaviors and decreased overall quality of life. The prevalence, course, and predictors of psychological distress after the diagnosis of colorectal cancer are to date not well described.

Epidemiology of prostate cancer in the Asia-Pacific region

The purpose of this paper was to examine and compare available data on incidence, mortality and survival for countries in the Asia-Pacific region. Incidence data were obtained from GLOBOCAN 2008, other online data sources and individual cancer registries. Country-specific mortality statistics by individual year were sourced from the World Health Organization Statistical Information System Mortality Database. All incidence and mortality rates were directly age-standardised to the Segi World Standard population and joinpoint models were used to assess trends. Data on survival were obtained from country-specific published reports where available. Approximately 14% (122,000) of all prostate cancers diagnosed worldwide in 2008 were within the Asia-Pacific region (10 per 100,000 population), with three out of every four of these prostate cancer cases diagnosed in either Japan (32%), China (28%) or Australia (15%). There were also about 42,000 deaths due to prostate cancer in the Asia-Pacific region (3 per 100,000). For the nine countries with incidence trend data available, eight showed recent significant increases in prostate cancer incidence. In contrast, recent decreases in prostate cancer mortality have been reported for Australia, Japan and New Zealand, but mortality has increased in several other countries. The lack of population-based data across most of the countries in this region limits the ability of researchers to understand and report on the patterns and distribution of this important cancer. Governments and health planners typically require quantitative evidence as a motivation for change. Unless there is a widespread commitment to improve the collection and reporting of data on prostate cancer it is likely that the burden of prostate cancer will continue to increase. Enhancing knowledge transfer between countries where there are differentials in capacity, policy and experience may provide the necessary impetus and opportunity to overcome at least some of the existing barriers.

A review of peer support in the context of cancer

Abstract Peer support interventions for people with cancer, their families, and friends have been widely used throughout the world. The present study reviewed the research literature on psychosocial oncology over the past decade to assess the prevalence and contribution of articles on peer support. Using CD-Rom databases, 25 articles were retrieved for review. In each article, patients or their family members were the target group for supportive interventions, which were primarily for the delivery of peer support and included either a qualitative or quantitative evaluation of the program. A definitional taxonomy for peer support interventions, which identified eight discrete settings, was derived from three key dimensions: style of supervision, interpersonal context, and mode of delivery. The studies suggested that peer support programs help by providing emotional and informational support from the perspective of shared personal experience. However, a paucity of research-particularly randomized controlled trials-was noted. The reasons may include inherent difficulties in isolating for study what is essentially a naturalistically occurring interpersonal dynamic from the complex social and community contexts from which it emanates. The authors discuss the gap between practice and theory in this area and recommend a broader and more inclusive view of supportive care for people with cancer.

Evaluation of a peer support program for women with breast cancer—lessons for practitioners

The present study aimed to describe how a volunteer peer support service assists women with breast cancer, and provides guidelines for practitioners in the development and implementation of such programmes. A two-phase evaluation of a breast cancer peer support program was undertaken to describe important attributes of the peer support intervention, the impact of the volunteer visit on womens self-reports of anxiety, and key indicators of a successful volunteer visit. Phase 1 included focus groups with 57 women previously treated for breast cancer. Phase 2 included a survey of 245 women also treated previously for breast cancer and visited by a Breast Cancer Support Volunteer. The key aspect of the peer support process was the bond of common experience leading to a decrease in social isolation, an increase in optimism about the future and reassurance about personal reactions and femininity. It is recommended that peer support programmes should aim to time support visits to coincide with the time when patient support needs are highest, that volunteers need to be recruited from a range of backgrounds and matched to patients most similar to them in way of life, and that peer support services should be embedded in a broad network of community support services. Copyright

The Impact of Body Mass Index and Physical Activity on Mortality among Patients with Colorectal Cancer in Queensland, Australia

Background: Few studies have investigated the impact of body mass index (BMI) and physical activity (PA) on mortality among colorectal cancer (CRC) patients and the results are inconsistent. We aimed to examine the impact of these lifestyle factors on all-cause and disease-specific mortality. Methods: Population-based longitudinal study followed 1,825 patients diagnosed with stages I to III primary CRC during 2003 to 2004 in Queensland, Australia for 5 years. Sociodemographics and clinical characteristics were obtained via questionnaires and medical records. Results: Participants with some level of PA following diagnosis had 25% to 28% lower risk of all-cause mortality within 5 years of diagnosis than sedentary participants [insufficiently active: HR = 0.72, 95% CI = 0.57–0.91; sufficiently active: HR = 0.75 (0.60–0.94)]; however, the differential for CRC-specific mortality was not significant. Increases in PA from five to 12 months postdiagnosis was associated with reduced CRC-specific mortality by 32% to 36% (increase ≤ 2 hour per week: HR = 0.68 (0.48–0.97); increase > 2 hour per week: HR = 0.64 (0.44–0.93) and 31% for all-cause mortality (increase >2 hour per week: HR = 0.69 (0.50–0.94). Compared with participants with healthy BMI, significant higher mortality risk was observed in underweight patients (all-cause: HR = 2.29 (1.47–3.59); CRC: HR = 1.74 (1.00–3.04), although lower risk in overweight (all-cause: HR = 0.75 (0.61–0.94); CRC: HR = 0.75 (0.59–0.97) and no difference in obese. Excessive weight loss was associated with increased mortality risk by three-fold but no difference in those who gained weight. Conclusions: Protective effects of being physically active and increasing that activity underlines the importance of interventions to increase activity levels among people being diagnosed with CRC. Impact: Increased mortality risks associated with being underweight or having weight loss over time is an important indicator for which clinicians, patients, and support personnel can monitor. Cancer Epidemiol Biomarkers Prev; 20(7); 1410–20. ©2011 AACR.

The validity of the distress thermometer in prostate cancer populations

The Distress Thermometer (DT) is widely recommended for screening for distress after cancer. However, the validity of the DT in men with prostate cancer and over differing time points from diagnosis has not been well examined.