Marrit A. Tuinman

Screening and referral for psychosocial distress in oncologic practice : Use of the distress thermometer

The objectives of this study were to validate the Distress Thermometer (DT) in the Netherlands and to examine its correspondence with a 46‐item Problem List, possible risk factors, and the wish for a referral.

Quality of life of testicular cancer survivors and the relationship with sociodemographics, cancer-related variables, and life events

Goals of workThe aim of this study was to (1) assess the quality of life (QoL) of testicular cancer survivors (TCSs) by comparing them to a reference group; (2) investigate the relationship between the QoL of TCSs and sociodemographics, cancer-related variables, and life events; and (3) identify TCSs at risk for an impaired QoL.Patients and methodsOf the TCSs approached, 50% (n=354) participated and completed a generic QoL questionnaire (RAND-36) once. Time since completion of treatment varied from 3 months to 24 years.Main results(1) TCSs had significantly higher mean scores on the subscales physical functioning (p=0.02) and pain (p=0.001), but lower mean scores on mental health (p=0.04) and vitality (p<0.001) than a reference group of men. The effect sizes of these differences were small to insignificant. (2) Employment status and chronic disease were the main correlates of the QoL of TCSs. Age, negative life events, type of treatment, and the experience of a second cancer event were moderately associated with some subscales as well. (3) The joint burden of unemployment and a chronic disease was the strongest predictor for an impaired functioning.ConclusionsOn a group level, TCSs experience a good QoL, but a small group appeared to be at risk for an impaired functioning, namely, those who were unemployed and had a chronic disease. The variance explained by the variables studied was low, indicating that more important predictors remain to be identified.

Marital and sexual satisfaction in testicular cancer survivors and their spouses

GoalTo compare marital and sexual satisfaction of men who survived testicular cancer (TC) and their spouses to a reference group, and to compare marital and sexual satisfaction of couples who had a relationship at time of diagnosis (couples during TC) to couples who developed a relationship after completion of treatment (couples after TC).Patients and methodsTwo hundred and nineteen couples during TC and 40 couples after TC completed the Maudsley Marital Questionnaire, a validated instrument to measure marital and sexual satisfaction.ResultsSurvivors and spouses of both couple groups reported similar marital satisfaction as men and women of the reference group. Survivors (t=2.9, p<0.01) and spouses (t=2.9, p<0.01) of couples during TC and survivors of couples after TC (t=1.9, p=0.05) reported less sexual satisfaction than the reference groups. Survivors of couples after TC reported less sexual satisfaction than survivors of couples during TC (F=4.0, p<0.05). Correlations between sexual satisfaction of survivors and spouses in couples during TC (r=0.76, p<0.001) and couples after TC (r=0.77, p<0.001) were high.ConclusionTesticular cancer did not appear to have a negative effect on marital satisfaction in couples during TC, although TC survivors and their spouses reported less sexual satisfaction than men and women of the reference group. Survivors who developed a relationship after completion of treatment seemed to form a vulnerable group: their sexual satisfaction was lower than that of men in the reference group and of TC survivors with a longer relationship. Besides that, they more often reported marital problems than their spouses did.

Negative and positive consequences of adolescent cancer 10 years after diagnosis : an interview-based longitudinal study in Sweden

The aim of this study was to provide insight into survivor‐reported negative and positive consequences of cancer during adolescence 10 years after diagnosis and compare these with consequences reported 3 and 4 years after diagnosis.

Sexual function, depressive symptoms and marital status in nonseminoma testicular cancer patients: a longitudinal study.

Goal: To longitudinally investigate sexual functioning in testicular cancer patients during the first year, and examine the effect of relationship status (with a partner or single) and depressive symptoms on sexual functioning.

The role of meaning in the prediction of psychosocial well-being of testicular cancer survivors

SummaryStressful life events, such as cancer, may threaten the belief that life is meaningful and this may have a negative effect on well-being. This study aimed at: (1) examining meaning in testicular cancer survivors (TCSs); (2) changes in outlook on life after testicular cancer (TC); (3) the contribution of meaning in the prediction of psychosocial well-being and cancer-related distress. A total of 354 TCSs completed relevant questionnaires. Results showed that: (1) TCSs experience their lives as meaningful; (2) most TCSs (60%) report a more positive outlook on life since TC; (3) meaning is the most important predictor for psychosocial well-being, but its relationship with cancer-related distress is weak. These results indicate that the cancer experience did not (permanently) disrupt the sense of meaning in TCSs. Furthermore, results confirm the idea that a sense of meaning has a positive effect on psychosocial well-being. Meaning appeared to have little effect on cancer-related distress. However, previous research has shown that this relationship may be too complex to unravel with a cross-sectional design. Therefore, it is suggested to further investigate the underlying interacting mechanisms between meaning and cancer-related distress.

The Effects of Testicular Cancer Treatment on Health-related Quality of Life

OBJECTIVES To prospectively describe the effects of adjuvant chemotherapy on health-related quality of life (HRQOL) among men with newly diagnosed non-seminoma germ cell tumors of the testis. Several characteristics of testicular cancer--young age at diagnosis, increasing incidence, and high survival rates--highlight the need for improved understanding of the variables influencing the survivorship experience. METHODS Participants (n = 116) were identified and recruited from the genitourinary services of 2 large medical centers--one in the United States and the other in The Netherlands. Baseline assessments were administered after diagnostic orchiectomy but before adjuvant treatment. Participants completed follow-up assessments after the completion of the chemotherapy regimen (or 3 months postdiagnosis for participants on surveillance regimens) and 12 months postdiagnosis. The 36-Item Short-Form Health Survey was used to measure HRQOL. RESULTS Findings indicated that men treated with chemotherapy reported significantly more bodily pain, poorer role physical functioning, poorer social functioning, poorer physical health, more fatigue compared with the men who did not receive chemotherapy at the post-treatment assessment. At the time of 12 month follow-up, HRQOL scores did not vary by treatment group, and scores were significantly higher than baseline HRQOL scores. No significant time by treatment group interactions were observed at the 12 month follow-up. CONCLUSIONS Results from this study indicate that chemotherapy is associated with only a temporary decrease in HRQOL. Other HRQOL domains, including mental functioning, role emotional, and general health perceptions, were not associated with treatment type at any of the assessment times.

Body image in cancer survivors: a systematic review of case-control studies.

PurposeThere is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether body image might be altered due to cancer.MethodsMedline, Cinahl, Embase, and PsycInfo were searched and after duplicate extraction, 1932 hits were retrieved and screened for eligibility. Included studies were rated on selection, measurement, and reporting bias.ResultsTwenty-five studies were identified using 19 different scales to measure body image. Ten studies reported a more negative body image in survivors, nine found no differences, three reported mixed findings, and three reported a more positive body image in survivors. Potential bias was common and 16 studies had at least three sources of potential bias. Less-biased studies (i.e., ≤2 sources of bias) hinted to weak differences between survivors and controls, favoring healthy controls. A meta-analysis could not be performed.ConclusionsThis review was long overdue and indicates a somewhat more negative body image in cancer survivors than healthy controls. However, numerous problems potentially biasing study results have been detected and firm conclusions cannot be drawn.Implications for Cancer SurvivorsFuture studies should recruit larger samples, match samples, and pay attention to how body image is conceptualized and measured in order to draw reliable conclusions as to whether body image is impaired in cancer survivors.

Distress, problems and referral wish of cancer patients: differences according to relationship status and life phase

The aim of this study is to examine differences in distress, problems and referral wish in cancer patients according to relationship status and life phase.

Psychosexual development and satisfaction in long-term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator

Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at‐risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis.