Maarten J. Fischer

Health-related quality of life in Dutch men with prostate cancer.

Abstract Prostate cancer is the most prevalent solid malignancy in men in the Netherlands. With regard to treatment, the focus of attention has shifted in the last decade from pure survival rates to health—related quality of life. HRQOL is affected differently by different treatments. The objective of this study is to assess the HRQOL related to treatment regime and time since diagnosis in Dutch men with prostate cancer. We conducted a cross—sectional study among 238 men with prostate cancer in a heterogeneous sample who filled in a general health—related quality—of—life measure (EORTC-QLQ-C30) and a prostate cancer specific quality—of—life instrument (the EORTC-QLQ-PR25) and a Joy—of—Life questionnaire. Men on hormonal treatment are doing worse compared with other treatments with respect to physical functioning, role functioning, fatigue, pain and sexual functioning. No differences were found between radical prostatectomy and radiation therapy on any of the HRQOL dimensions nor for time since diagnosis. In hormonal therapy, men who are diagnosed longer than two years ago report a worse cognitive functioning and more burdens from urinary problems.

Stick Together: A Nordic Walking Group Intervention for Breast Cancer Survivors

Axillary lymph node dissection and axillary radiation as part of breast cancer treatment often result in arm and shoulder morbidity and limitations in daily functioning. Over and above the general benefits for cardiorespiratory fitness, Nordic Walking particularly targets at the muscles of the upper extremities and shoulder. This may increase shoulder range of motion and lead to a reduction in functional limitations. The aim of this study was to offer a Nordic Walking intervention to women after treatment for breast cancer and to investigate changes in subjective well-being and shoulder function. Three supervised Nordic Walking courses were organized (2009–2011). The intervention consisted of ten weekly 1-hour sessions focusing on upper body strength and condition. In total, 28 women participated in one of the cohorts. Results showed that after 10 weeks, patients’ vitality had improved, whereas perceived shoulder symptom severity and limitations in daily activities had decreased. Goniometric data indicated that range of motion (forward flexion, abduction, and external rotation) of the affected shoulder improved significantly within 10 weeks of training. Group interviews at 6 months follow-up confirmed that patients had appreciated the physical and psychosocial benefits of the intervention. These benefits outweighed the practical disadvantages. Patient selection, assessment and training should take place under (para-)medical supervision and group instructors should have the knowledge and skills to work with a group of recent cancer survivors. Results from this explorative study suggest that Nordic Walking is a feasible and potentially valuable tool in the rehabilitation of patients with breast cancer.

Routine Monitoring of Quality of Life for Patients with Breast Cancer: An Acceptability and Field Test

As part of the development of a quality of life monitor for women with breast cancer, a qualitative acceptability test was conducted among 10 patients, to assess their suggestions for improvement. Next, a field test was conducted among 50 women with breast cancer receiving radiotherapy, chemotherapy, or both treatments to examine the use of the monitor in daily practice and to assess physicians’ and patients’ experiences with the monitor. Although patients in general held a positive attitude toward the monitor and compliance was high, patients regularly were unsure about how the quality of life information was used by physicians.

Shared decision making in oncology: A model based on patients’, healthcare professionals’, and researchers’ views

To construct a model of shared decision making (SDM) about cancer treatment by conducting an extensive consultation of stakeholders, informed by the literature.