Immune checkpoint inhibitors (ICIs) have recently shown tremendous promise in the treatment of diverse cancers. The available data suggests that ICIs are well tolerated in terms of health-related ...quality of life (HRQOL) compared to other anticancer therapies. However, it appears that instruments currently used to evaluate HRQOL in this context may fail to capture important symptomatology unique to ICIs. This systematic review was designed to assess the adequacy of methods used to report HRQOL in cancer patients treated with ICIs and to identify the quality of life scales used.
A systematic review was performed (systematic registration number: PROSPERO: CRD42019121427). A search of the PubMed, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences collection, and SocINDEX databases was carried out for publications in English and in French. Relevant databases were searched from the earliest records through to March 2019. Publications were selected if they reported on HRQOL in patients with cancer treated by ICIs. Risk of bias was scored using the Cochrane Collaboration bias assessment tool.
Our search identified 144 publications between 2012 and 2019, of which 15 RCTs met the inclusion criteria. The results suggest that even though the overall reporting of HRQOL was deemed to be of good quality, the data available was marred by methodological aspects such as the lack of HRQOL research hypotheses and the lack of questionnaires validated for cancer patients treated with immunotherapy.
This study provides a comprehensive analysis of the current state of the art and identifies gaps in knowledge on HRQOL analysis with respect to ICIs. It also suggests avenues for further research.
Highlights • First review of patient education interventions for colorectal cancer with stoma. • Very few studies (N = 15) are available in this field. • Patient education interventions are ...heterogeneous in delivery and outcomes. • More quantitative research is needed to define best practices.
Objective: To assess colorectal cancer survivors' quality of life (QoL) and fatigue according to stoma status.
Methods: In this large-scale national survey, we examined and compared QoL (SF-12) and ...fatigue (QLQ-C30) of colorectal cancer survivors according to stoma status and against population norms. Of the 487 colorectal cancer survivors who participated in the VICAN survey, 43 had a reversed stoma. We randomly selected 43 survivors without stoma as a comparison group.
Findings: Colorectal cancer survivors had lower QoL scores compared to population norms. Fatigue affected survivors even two years after diagnosis. Participants with a reversed stoma scored lower on the physical QoL scale than participants without stoma.
Conclusion: QoL and fatigue are impaired during a considerable period after cancer diagnosis and differ according to stoma status.
Implications for psychosocial providers: Interventions aimed at improving QoL and fatigue for colorectal cancer survivors should be offered on a long-term basis, even two years after diagnosis.
Objective: This study aims to evaluate the feasibility, acceptability, and efficacy of StomieCare for rectal cancer patients undergoing surgery with a temporary stoma. StomieCare (three individual ...sessions) comprises thematic discussions, information and education, and teaching problem-solving and cognitive restructuring. Methods: Thirty-seven rectal cancer participants treated by surgery and temporary stoma were recruited and randomized to control (routine care approach, n = 20) and intervention (routine care and StomieCare, n = 17) groups. Outcomes were psychological distress (anxiety and depression, HADS), body image (BIS, ESS), and quality of life (FACT-C), at one week before surgery (T1) and 3 months after stoma closure (T2). Interand intragroup statistical analyses were performed. Results: This study demonstrated that StomieCare is feasible and acceptable. At T2, depression scores were higher for controls than for the intervention group. The mean scores for quality of life, depression, and body image decreased in the control group but remained stable in the intervention group. Anxiety scores significantly decreased between T1 and T2 only for the control group. Conclusion: StomieCare is a feasible and acceptable intervention for the prevention of depressive symptomatology.
L’objectif de cette étude est d’évaluer la faisabilité, l’acceptabilité et l’efficacité d’une intervention psychosociale en individuel (appelée StomieCare) auprès de patients atteints d’un cancer du rectum et traités par chirurgie avec stomie temporaire. Cette intervention, en trois séances individuelles, comprend des discussions thématiques autour de problèmes communs relatifs à la maladie et/ou la stomie comme l’impact du cancer et de ces traitements sur la qualité de vie, l’estime de soi, d’apport d’informations et d’apprentissage de techniques (résolution de problème et restructuration cognitive). Trente-sept patients atteints d’un cancer du rectum et traités par chirurgie avec stomie temporaire ont été recrutés et randomisés soit dans le groupe contrôle (prise en charge traditionnelle, n = 20) soit dans le groupe intervention (prise en charge traditionnelle et StomieCare, n = 17). Une semaine avant l’opération (T1) et trois mois après le rétablissement de continuité (T2), tous les patients ont rempli la HADS pour évaluer l’anxiété et la dépression, la BIS pour l’image du corps, l’ESS pour la honte liée àl’image du corps et la FACT-C pour la qualité de vie. Des analyses statistiques intergroupes et intragroupes ont été réalisées.Les critères de faisabilité et d’acceptabilité sont satisfaisants. A T2, les scores de dépression du groupe contrôle sont significativement plus élevés que ceux du groupe intervention. A T2, et uniquement pour le groupe contrôle, il y a une altération significative des scores de qualité de vie, dépression et image du corps. Aucune différence significative n’est observée pour le groupe intervention. L’anxiété diminue entre T1 et T2 de manière significative uniquement pour le groupe contrôle. Pour conclure, StomieCare semble être une intervention faisable et acceptable à visée préventive de la symptomatologie dépressive.
The risks of developing cancer are significantly affected by our lifestyle and environment. While there are several uncontrollable risk factors, we can modify our lifestyle and our environment to ...reduce the increased threat of cancer. This systematic review aims to evaluate the methodological assessment used to evaluate attitudes about cancer risk factors among the general population. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Programme (CASP) checklists were used to assess the methodology of the included studies. Thirty-one manuscripts met the inclusion criteria with a majority of them focusing on attitudes to several cancer risk factors and six on specific cancer location risk factors. This systematic review highlights the diversity of notions used around attitudes and methods used in the method of administering the survey, as well as the format of the questions and the response scales. It is thus difficult to compare data between different countries. However, cancer is a global problem. Harmonizing methods could allow a comparison of data between countries. Recommendations to this effect are suggested.
Cette recherche a pour objectif d’explorer l’évolution de l’image du corps, de l’anxiété et de la dépression au cours du traitement chirurgical chez des patients atteints d’un cancer du rectum et ...porteurs d’une stomie temporaire.
La veille de l’opération (T0), un mois après l’opération (T1) et deux mois après le retrait de la stomie temporaire (T2), la Hospital and Anxiety Depression Scale et le Questionnaire d’Image du Corps ont été complétés par 31 participants (13 femmes et 18 hommes, Mâge=62,48) atteints d’un cancer du rectum et traités par exérèse rectale avec stomie temporaire.
La création d’une stomie temporaire entraîne une altération significative de la satisfaction corporelle (F (2,58)=6,402, p<0,01), altération qui ne persiste pas à T2 et une augmentation des scores de dépression (F (2,60)=6,935, p<0,01) qui persiste à T2. À T0 et T2, la satisfaction corporelle est corrélée négativement avec l’anxiété et la dépression (p<0,05) mais pas à T1.
L’exérèse rectale avec stomie temporaire pour cancer du rectum a des répercussions psychologiques majeures. Il conviendrait de mettre en place un accompagnement psychologique et d’en évaluer l’efficacité.
In 2012, rectal cancer represented 30 % of colorectal cancers. In the case of cancer, three treatments are available, alone or associated: radiotherapy, chemotherapy and surgery. The main treatment for rectal cancer is surgery and more particularly rectal resection. The most important complication of this surgery is fistula. To reduce the risk, surgeons put a temporary stoma who can have repercussions like psychological difficulties, alteration of body image for example. The aims of this research were to explore the evolution of body satisfaction, anxiety and depression in the surgical treatment and study the associations between these variables.
Participants are recruited in a visceral surgery department of CHU of Bordeaux. On the eve of the operation (T0), one month after the operation (T1) and two months after reversal stoma (T2), the Hospital Anxiety and Depression Scale and the Questionnaire d’Image du Corps were completed by 31 participants (13 women et 18 men, Mage=62.48 years) diagnosed with rectal cancer treated with rectal excision and temporary stoma.
Temporary stoma had an impact on body satisfaction (F (2.58)=6.402, P<0.01) but the alteration of body satisfaction does not persist after reversal stoma. The mean score of body satisfaction at T0 (M=64.16, SD=10.92) was significantly (t (30)=3.075, P<0.01) higher than mean score of body satisfaction at T1 (M=55.97, SD=12.48). The mean score of body satisfaction at T1 was significantly lower (t (30)=2.881, P<0.01) than mean score of body satisfaction at T2 (M=61.51, SD=12.47). There was no significant difference between the average scores of body satisfaction at T0 and T2 (t (30)=1.065, P>0.05). In total, 19.3 % of participants have severe anxiety and 4.3 % severe depression. The mean scores of anxiety at T0, T1 and T2 were not significantly different (F (2,58)=1.163, P>0.05). Temporary stoma had an impact also depression (F (2.60)=6.935, P<0.01) who persist after reversal stoma. The mean score of depression at T0 (M=2.94, SD=2.5) was significantly lower than the mean score of depression at T1 (M=5.14, SD=3.15) and at T2 (M=4.14, SD=3.07). Finally, body satisfaction was negatively correlated with anxiety and depression at T0 and T2 (P<0.05).
Cancer remains the second leading cause of death in our advanced societies. In France and oncology, patients's psychological distress would be undervalued and insufficiently supported. That is why we focused on this variable and also on body image from a target population, yet little studied: patients with rectal cancer and temporary ostomy. With advances in recent years in the treatment of rectal cancer, sphincter preservation becomes more systematic, to the detriment of the final stoma, but it involves the implementation of a temporary ostomy. As we have seen, surgical treatment with temporary stoma for rectal cancer appears to have psychological repercussions. In a society where the fashion and advertising standards valuing a beautiful body hurt the ostomate person where their suffering is often ignored and little discussed, it seems essential and necessary to set up psychological counseling and measure its effectiveness.
Objective: To assess colorectal cancer survivors' quality of life (QoL) and fatigue according to stoma status.Methods: In this large-scale national survey, we examined and compared QoL (SF-12) and ...fatigue (QLQ-C30) of colorectal cancer survivors according to stoma status and against population norms. Of the 487 colorectal cancer survivors who participated in the VICAN survey, 43 had a reversed stoma. We randomly selected 43 survivors without stoma as a comparison group.Findings: Colorectal cancer survivors had lower QoL scores compared to population norms. Fatigue affected survivors even two years after diagnosis. Participants with a reversed stoma scored lower on the physical QoL scale than participants without stoma.Conclusion: QoL and fatigue are impaired during a considerable period after cancer diagnosis and differ according to stoma status.
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