Return to work of cancer patients

To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy | BMJ Open

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Objectives: The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes.

Conclusions: RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.

Full reference: Leensen, M.C.J. et al. (2017) Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 7:e014746.

Cancer as a stressful life event: Perceptions of children with cancer and their peers

Howard Sharp, K.M. Cancer. Published online: 4 May 2017

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Background: The medical traumatic stress model is commonly applied to childhood cancer, assuming that the diagnosis of cancer is a traumatic event. However, to the authors’ knowledge, little is known regarding what specifically children perceive as stressful about cancer or how it compares with other stressful events more often experienced by children.

 

Conclusions: Children do not necessarily view their cancer experience as their most stressful life event. The findings of the current study suggest that the diagnosis of cancer might be better viewed as a manageable stressor rather than a major trauma, and are consistent with the change in the fifth edition of the DSM to eliminate the diagnosis of a life-threatening illness as a qualifying trauma for PTSD.

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Issues of Survivorship and Rehabilitation in Soft Tissue Sarcoma

Gerrand, C. & Furtado, S. Clinical Oncology | Published online: 22 April 2017

As the number of survivors of extremity soft tissue sarcoma increases, so does the need to understand the experience of survivors and develop measures, systems and services that support rehabilitation into normal life roles.

Survivorship includes considerations of the physical, psychological and social domains, of which the physical sequelae of treatment are the best characterised in the literature. The survivorship experience may include disability, pain, lymphoedema, psychological problems, as well as difficulty with employment, relationships and lower quality of life.

Rehabilitation strategies for extremity sarcoma patients must be personalised, holistic and begin early in the pathway, ideally before the first treatment intervention.The International Classification of Functioning, Disability and Health model is a useful framework for combining assessments, including objective outcome measures, which can be combined into a rehabilitation prescription. Research is needed to develop an evidence base for rehabilitation interventions to support patients with extremity soft tissue sarcoma.

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Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer

Parada, H. et al. (2017) JNCI: Journal of the National Cancer Institute. 109(6)

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Background: Grilled, barbecued, and smoked meat intake, a prevalent dietary source of polycyclic aromatic hydrocarbon (PAH) carcinogens, may increase the risk of incident breast cancer. However, no studies have examined whether intake of this PAH source influences survival after breast cancer.

Conclusion: High intake of grilled/barbecued and smoked meat may increase mortality after breast cancer.

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Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls

Janelsins, M.C. et al. Journal of Clinical Oncology. Published online: December 28 2016

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Purpose: Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study.

Conclusion: Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

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Survivorship after lower gastrointestinal cancer

Frick, M.A. et al. Cancer. Published online: 5 January 2017

Background: There is significant need for quality follow-up care to optimize long-term outcomes for the growing population of lower gastrointestinal (GI) cancer survivors. Patient-reported outcomes (PROs) provide valuable information regarding late and long-term effects (LLTEs).

Conclusions: For lower GI cancer survivors, it is feasible to obtain PROs from an Internet-based survivorship tool. Survivors report a wide spectrum of LLTEs, and these can be used to inform counseling at the time of diagnosis and to help anticipate and respond to disease-related and treatment-related sequelae during follow-up. The authors are among the first to report on PROs in anal cancer survivors. Further investigation on the impact of SCPs on health care communication and use is needed.

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Using patient experience to improve outcomes after treatment

Proven, D. & Rennie, C. (2016) Cancer Nursing Practice. 15(10) pp. 19-22.

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The Transforming Care After Treatment (TCAT) programme aims to improve care for people living with and beyond cancer in Scotland. The direct involvement of people affected by cancer is integral to the programme’s design and its overall success. Under the TCAT programme a project team in NHS Ayrshire and Arran has worked with people affected by cancer to review and redesign its breast and colorectal cancer pathways. The outcomes of the project have demonstrated the value of ongoing user involvement in the development of an intervention. This allows for rapid feedback and insight into experiences, and services have become more efficient, effective and person-centred.

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