Association between self-perception of aging, view of cancer and health of older patients in oncology

The authors hypothesize that more negative self-perception of aging (SPA) and view of cancer could be linked to worse physical and mental health outcomes in cancer patients | BMC Cancer

Image source: Danilo Vidovic – Flickr // CC BY 2.0

Identifying older people affected by cancer who are more at risk of negative health outcomes is a major issue in health initiatives focusing on medical effectiveness. In this regard, psychological risk factors such as patients’ perception of their own aging and cancer could be used as indicators to improve customization of cancer care.

Negative SPA and/or view of cancer at baseline are associated with negative evolution of patients’ physical and mental health. Moreover, when the evolution of SPA and cancer view were taken into account, these two stigmas are still linked with the evolution of mental health. In comparison, only a negative evolution of SPA was linked to worse physical health outcomes.

Full reference: Schroyen, S. et al. (2017) Association between self-perception of aging, view of cancer and health of older patients in oncology: a one-year longitudinal study. BMC Cancer. 17:614

Symptom appraisal and help-seeking in people with symptoms suggestive of pancreatic cancer

This study sought to explore symptom appraisal and help-seeking among patients referred to secondary care for symptoms suggestive of pancreatic cancer | BMJ Open

Pancreatic cancer has poor survival rates due to non-specific symptoms leading to later diagnosis. Understanding how patients interpret their symptoms could inform approaches to earlier diagnosis.

Qualitative analysis of semistructured in-depth interviews. Data were analysed iteratively and thematically, informed by the Model of Pathways to Treatment.

Time from first symptoms to first presentation to healthcare ranged from 1 day to 270 days, median 21 days. We identified three main themes. Initial symptom appraisal usually began with intermittent, non-specific symptoms such as tiredness or appetite changes, attributed to diet and lifestyle, existing gastrointestinal conditions or side effects of medication. Responses to initial symptom appraisal included changes in meal type or frequency, or self-medication. Symptom changes such as alterations in appetite and enjoyment of food or weight loss usually prompted further appraisal. Triggers to seek help included a change or worsening of symptoms, particularly pain, which was often a ‘tipping point’. Help-seeking was often encouraged by others. We found no differences in symptom appraisal and help-seeking between people diagnosed with cancer and those with other conditions.

Full reference: Mills, K. et al. (2017) Understanding symptom appraisal and help-seeking in people with symptoms suggestive of pancreatic cancer: a qualitative study. BMJ Open. 7:e015682.

Publishing national chemotherapy data has helped NHS hospitals make changes that should improve treatment

It’s often research into new drugs that makes headlines. But examining routine data can also help doctors continually improve how they use treatments already available | CRUK Blog

To do that the NHS needs to look at how these treatments are being used and how different patients fare following treatment. Last year, we worked with Public Health England to do exactly that.

Our world-first study of patients treated for breast and lung cancer in 2014 gave us a national picture of what happened to patients following treatment with chemotherapy, ‘targeted’ drugs and immunotherapy.

The study was made possible by routine data collected by Public Health England as part of the treatment of all patients across the English NHS. And for the first time each English NHS hospital trust was able to see how well their breast and lung cancer patients fared in the first 30 days after receiving these treatments compared with other trusts.

This measure, called ‘30-day mortality’, is really useful. If a patient dies in that short window of time, it’s unlikely they benefitted from the treatment and they might still have experienced its side effects, even if it didn’t directly lead to their death.

For those patients, other types of treatment and support might have led to a better outcome. But the only way to know this is by giving treatment teams data to help them spot where they could make improvements.

Read the full post here

Risk factors for falls in older patients with cancer

A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer | BMJ Supportive & Palliative Care

This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment. Vitamin D and bone densitometry were performed.

Falls are common in older patients with cancer and lead to adverse clinical outcomes. Major depression, functional impairment, frailty, dementia and low social support were risk factors for falls. Heightened awareness and targeted interventions can prevent falls in older patients with cancer.

Full reference: Zhang, X. et al. (2017) Risk factors for falls in older patients with cancer. BMJ Supportive & Palliative Care. Published Online: 31 August 2017.

Mindfulness-Based Interventions and Sleep Among Cancer Survivors

The purpose of this critical examination is to present results from a critical analysis of randomised controlled trials and provide a synthesis of this body of work | Current Oncology Reports

Sleep problems among cancer survivors are gaining research attention. To our knowledge, there have been six randomized control trials published from 2013 to 2015 that test the effects of mindfulness-based interventions (MBIs) on sleep as a primary or secondary outcome.

Our examination of the literature highlights important methodological issues and variability among trials. We conclude our review by offering solutions to facilitate more scientific rigor in future studies.

Full reference: Christodoulou, G. & Black , D.S. (2017) Mindfulness-Based Interventions and Sleep Among Cancer Survivors: a Critical Analysis of Randomized Controlled Trials. Current Oncology Reports. Vol. 19 (Issue 09)
Article 60.

Making cervical screening more accessible

Attendance for cervical screening has been falling year on year. This professional resource from Public Health England aims to address this decline in attendance by presenting recommendations that can help increase access to screening and awareness of cervical cancer.

Image source: http://www.gov.uk

Download the infographics, references and a shorter version of this publication here

Cancer in the West Midlands

This report provides an overview of the burden of cancer and the extent of the identified risk factors, across the West Midlands. | Public Health England

The aim of this report is to equip care providers and policy makers with an insight into the burden of cancer, as well as providing an overview of the extent of the identified risk factors, across the West Midlands population.

It is intended to be used by commissioners of health services to enable more timely diagnosis and improve treatment pathways, and also by local authority commissioners in terms of the wider prevention agenda.

Full document:  Cancer in the West Midlands.

 

Trial to test new drug in patients with advanced cancer

Cancer Research UK launches trial to test new drug in patients with advanced cancer | Cancer Research UK

A clinical trial to test a new cancer drug in patients with advanced solid tumours, launches in four centres across the UK, through Cancer Research UK’s Centre for Drug Development.

This early phase trial will test the safety and tolerability of the drug and establish the recommended dose for patients with a variety of cancers including advanced bowel, lung, ovarian, urothelial, pancreatic, breast, head and neck, and oesophageal cancer.

In the first part of the trial, groups of patients will receive increasing doses of the drug, called LY3143921 hydrate, to find the safest dose that best targets the cancer cells. The drug, discovered by Eli Lilly, was brought to Cancer Research UK through the charity’s Clinical Development Partnership scheme.

In the second part, larger groups of patients will receive the highest tolerated dose, so that researchers can investigate how the drug is working on the cancer cells.

The drug has not yet been tested in people but has shown promise in mice by selectively inhibiting Cdc7, a protein that helps cells to reproduce correctly.

Full story at Cancer Research UK

Many young cancer patients do not receive adequate fertility information and support

All cancer patients of reproductive age should be provided with fertility information and referrals for fertility preservation, researchers urge | ScienceDaily

In the analysis of 23 relevant studies, investigators found that many clinicians are broadly informed about the risk to their patients’ fertility brought about by cancer treatment, but many factors hinder the appropriate discussions and referrals needed to provide adequate fertility support to patients of reproductive age. For example, some oncology clinicians may lack appropriate fertility knowledge and be unsure whose role it is to provide fertility support.

• Overview via ScienceDaily
• Original research article

Developing a model for embedded palliative care in a cancer clinic

Describe the development and key features of a model for embedded palliative care (PC) for patients with advanced kidney cancer or melanoma seen in a cancer clinic | BMJ Supportive & Palliative Care

Methods: Retrospective chart review of patients following an initial phase and then a prospective review following the implementation of a model for embedded PC.

Results: In the initial phase, 18 patients were seen for a total of 53 visits; 78% were seen more than once, with a mean of three visits per patient. In the model phase, 46 patients were seen for a total of 163 visits; 74% were seen more than once, with a mean of 3.5 visits. Demographics were similar between the two groups. Content of the first PC visit in the initial and model phases was symptom management (61% and 57%), psychosocial support/relationship building (28% and 35%) and advance care planning/decision-making support (11% and 8%), respectively.

Conclusions: The initial phase demonstrated acceptability and feasibility of a model for embedded PC for patients and the oncology team. Establishment of specific eligibility criteria and screening to identify eligible patients in the model phase led to an increased uptake of PC for patients with advanced kidney cancer and melanoma in a cancer clinic.

Full reference: DeSanto-Madeya, S. et al. Developing a model for embedded palliative care in a cancer clinic. BMJ Supportive & Palliative Care. Vol. 07 (Issue 03) pp.247-250.